Ultrasonic multimodal imaging in the identification of ischemic segments and the e-valuation of left ventricular function in patients with myocardial infarction
Objective To investigate the clinical application value of transthoracic echocardiography(TTE),two-dimen-sional speckle tracking imaging(2D-STI)and lung ultrasound in the identification of ischemic segments and assessment of left ventricular function in different types of myocardial infarction(MI).Methods A total of 93 patients with MI in the Cardiology Department of Quanzhou First Hospital were randomly selected,including 45 cases of NSTEMI and 48 cases of STEMI.All pa-tients underwent TTE,2D-STI,and lung ultrasound within 24 hours prior to coronary angiography.TTE was used to observe whether there was regional wall motion abnormalities(RWMA),and the left ventricular ejection fraction(LVEF),left atrial volume index(LAVI),pulmonary artery systolic blood pressure(PASP),mitral valve flow E peak,mitral annulus e'peak were measured and E/e'was calculated.2D-STI was used to analyze the longitudinal peak strain(LPS)and global longitudinal peak strain(GLPS)of each segment of the left ventricular wall;Pulmonary ultrasound was used to observe and calculate the B-line integral of the lungs;B-type natriuretic peptide(BNP)was urgently checked upon admission.The coincidence rate between STE and 2D-STI was compared with the results of coronary angiography,and the correlation between TTE parameters,GLPS,lung B-line score and BNP in the two groups was analyzed.Results The coincidence rate of 2D-STI ischemia segment in the NSTEMI group was significantly higher than that of TTE(P<0.05),LVEF was weakly correlated with GLPS,lung B-line in-tegral and BNP in the NSTEMII group,but the correlation were strong in the STEMI group.GLPS and pulmonary B-line scores were strongly positively correlated with BNP,and pulmonary B-line scores were strongly correlated with E/e',LAVI and PASP in the two groups.Conclusion TTE combined with 2D-STI can improve the identification rate of ischemic segments in patients with NSTEMI;TTE combining with lung ultrasound can provide an objective imaging basis for the evaluation of left heart func-tion and pulmonary congestion in MI patients;and ultrasound multimodal imaging in MI patients has certain clinical significance.