Predictive value of myocardial contrast echocardiography combined with real-time three-dimensional echocardiography for major adverse cardiovascular events in elderly patients with acute myocardial infarction after percutaneous coronary intervention
Objective To investigate the clinical value of myocardial contrast echocardiography(MCE)combined with real-time three-dimensional echocardiography(RT-3DE)in predicting major adverse cardiovascular events(MACE)in elderly patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 95 elderly patients with AMI who underwent PCI in our hospital were selected and divided into MACE group(31 cases)and non-MACE group(64 cases)according to the occurrence of MACE.Peak intensity(A value),blood flow velocity(β value)and myocardial blood flow(A·β value)in the plateau phase were obtained by MCE.Left ventricular ejection fraction(LVEF),left ventricular systolic peak ejection rate(PER),left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV)were obtained by RT-3DE.The differences of above parameters of the two groups were compared.Multivariate Logistic regression analysis was used to screen the independent influencing factors of MACE in elderly patients with AMI after PCI.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of MCE,RT-3DE parameters,and their combination for MACE in elderly patients with AMI after PCI.Results A·β value,LVEF and PER in the MACE group were lower than those in the non-MACE group,and LVESV was higher than that in the non-MACE group(all P＜0.001).Multivariate Logistic regression analysis showed that A·β value,LVEF,PER and LVESV were independent influencing factors of MACE in elderly patients with AMI after PCI(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of A·β value,LVEF,PER,and LVESV for predicting MACE in elderly patients with AMI after PCI were 0.768,0.675,0.792 and 0.786,respectively.The AUC of their combination was 0.931,which was higher than that of each parameter alone(Z=5.470,3.028,5.963,5.315,all P＜0.05).Conclusion MCE combined with RT-3DE can better help to predict MACE in elderly patients with AMI after PCI,which has higher clinical value.
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