Early paradoxical motion under cardiac magnetic resonance can be used to evaluate postoperative cardiac function in patients with acute myocardial infarction from multiple angles
Early paradoxical motion under cardiac magnetic resonance can be used to evaluate postoperative cardiac function in patients with acute myocardial infarction from multiple angles
Objective To explore correlations of early contradictory movements with clinical characteristics,risk stratification,and clinical prognosis in patients with acute myocardial infarction(AMI).Methods This study consecutively enrolled 77 first-onset AMI patients who were hospitalized and diagnosed in our department from June 2022 to April 2024,including 53 males and 24 females,with a mean age of 61.75±11.92 years.All patients underwent culprit-only revascularization after admission and received cardiac magnetic resonance(CMR)imaging within an average of one week after surgery.According to whether there were contradictory movements in myocardial strain,the included patients were divided into contradictory movement group(n=47)and non-contradictory movement group(n=30).All patients were followed up for an average of 7 months to record the occurrence of major adverse cardiovascular events(MACEs).Results Patients in the contradictory movement group had significantly increased brain natriuretic peptide levels and neutrophil/lymphocyte ratio,but decreased lymphocyte counts than those in the non-contradictory movement group(P＜0.05).There was no significant difference in the number of diseased vessels,culprit vessels,and Gensini score between the contradictory movement group and the non-contradictory movement group(P＞0.05).CMR results showed that patients in the contradictory movement group had significantly larger infarct areas visualized by LGE,higher left ventricular end-systolic volume index and microcirculation dysfunction volume than those in the non-contradictory movement group(P＜0.05);while the former group had obviously lower left atrial ejection fraction,left ventricular ejection fraction,radial strain of the infarcted segment,circumferential strain of the infarcted segment,longitudinal strain of the infarcted segment,global radial strain,global circumferential strain,and global longitudinal strain than those in the latter group(P＜0.05).Furthermore,binary logistic regression analysis showed that neutrophil/lymphocyte ratio,circumferential strain of the infarcted segment,and global longitudinal strain could predict whether patients had contradictory movements independently.In addition,the incidence of MACEs was significantly higher in the contradictory movement group than in the non-contradictory movement group(P＜0.05),with contradictory movement being an independent risk factor for MACEs in AMI patients after successful revascularization(HR=2.551).Conclusion CMR can facilitate the evaluation of the postoperative cardiac function status of AMI patients from multiple perspectives,which may provide a valuable reference for applying personalized treatment and improving the clinical prognosis of patients.
关键词
急性心肌梗死/心脏磁共振/早期矛盾运动/心功能状态/不良心血管事件
Key words
acute myocardial infarction/cardiac magnetic resonance imaging/early contradictory movements/cardiac function status/major adverse cardiovascular events
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