左室心肌做功与STEMI患者急诊PCI术后出现左室重构的相关性研究
Correlation analysis of left ventricular global myocardial work and left ventricular remodeling after emergency PCI in patients with ST-segment elevation myocardial infarction
徐芳 1徐俊杰 2王莉 1任骋 1钱雪松 1宋佳贤1
作者信息
- 1. 苏州大学附属张家港医院/张家港市第一人民医院 心血管内科,江苏 张家港 215600
- 2. 苏州大学附属张家港医院/张家港市第一人民医院 急诊科,江苏 张家港 215600
- 折叠
摘要
目的:探讨左室心肌做功与急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠脉介入术(PCI术)后出现左室重构的相关性.方法:自2019 年1 月到2020 年12 月连续纳入行急诊PCI术后的 54 例STEMI患者[男45 例,(59.7±12.4)岁],分别在术后48h以及术后6 个月行常规心超、斑点追踪超声以及左室心肌做功检查,测得常规心超数据、左室纵向应变和左室心肌做功各指标,以术后 6 个月左室舒张末期容积增大≥15%作为左室重构的标准,探讨左室心肌做功与左室重构的相关性.结果:17 例患者在术后 6 个月出现左室重构,左室重构患者组48h的左室整体做功指数明显低于左室无重构组[(1 099.7±426.1)mmHg%vs.(1 582.3±557.6)mmHg%,P =0.003].多因素回归分析显示,48 h左室整体做功指数是行急诊PCI术后的STEMI患者出现左室重构的独立危险因素.ROC曲线下面积为0.757(95%CI为0.622～0.891,截点为1 382 mmHg%,特异度为64.9%,敏感度为82.4%,P =0.035).结论:48 h左室整体做功指数是行急诊PCI术后STEMI患者出现左室重构的独立危险因素.
Abstract
Objective:To explore the correlation analysis of left ventricular global myocardial work(LVGMW)and left ventricular remodeling(LVR)after emergency percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods:From January 2019 to December 2020,54 consec-utive patients(45 males)who underwent emergency PCI for AMI were included with an average age of(59.7±12.4)years old.Comprehensive echocardiography was performed for patients who underwent emergency PCI for STEMI 48 hours(48 h)and 6 months after PCI.Left ventricular ejection fraction(LVEF),left ventricular end-di-astolic volume(LVEDV),left ventricular global longitudinal strain(LVGLS)and left ventricular global work indices(LVGWI)were assessed.Left ventricle(LV)remodeling(LVR)was defined as an increase of 15%of LVEDV from 48 hours to 6 months after surgery.Multivariate Logistic regression analysis was used to evaluate the correlation of LVGMW and LVR.Results:Left ventricular remodeling occurred in 17 patients at 6 months after surgery.48 h left ventricular global work index(LVGWI)in the LVR group was significantly lower than that in non-LVR group[(1 099.7±426.1)mmHg%vs.(1 582.3±557.6)mmHg%,P =0.003].Multivariate Logistic regression anal-ysis showed that LVGWI within 48 h was an independent risk factor for LVR after emergency PCI in STEMI pa-tients,the area under ROC curve was 0.757(95%CI 0.622-0.891,cut-off point 1 382 mmHg%,specificity 64.9%,sensitivity 82.4%,P =0.035).Conclusion:Lower48 h LVGWI was an independent risk factor for LVR in STEMI patients undergoing emergency PCI.
关键词
左室心肌做功/左室整体做功指数/急性ST段抬高型心肌梗死/经皮冠脉介入术/左室重构Key words
left ventricular global myocardial work/left ventricular global work index/ST-segment elevation my-ocardial infarction/percutaneous coronary intervention/left ventricular remodeling引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据