Value of left ventricular shape index and eccentricity index of gated myocardial perfusion imaging in the evaluation of left ventricular remodeling in patients with myocardial infarction
Objective To investigate the clinical value of left ventricular shape index(SI)and ec-centricity index(EI)in evaluating left ventricular remodeling.Methods A retrospective analysis was per-formed on 324 patients(264 males,60 females,age(62.5±11.8)years)diagnosed with myocardial infarc-tion(MI)and 113 healthy controls(HC;47 males,66 females,age(57.8±10.7)years)who received ga-ted myocardial perfusion imaging(GMPI)in First Hospital of Shanxi Medical University from January 2016 to September 2020.SI(end-diastolic SI(EDSI),end-systolic SI(ESSI)),EI and left ventricular function parameters(end-diastolic volume(EDV),end-systolic volume(ESV),left ventricular ejection fraction(LVEF),summed motion score(SMS),summed thickening score(STS),peak ejection rate(PER)and peak filling rate(PFR))were obtained by quantitative gated SPECT(QGS)software.Propensity score(PS)inverse probability of treatment weighting(IPTW)was used to balance the intergroup covariates.The differences and correlations of EDSI,ESSI,EI and left ventricular function parameters between patients in MI group and HC group were analyzed.ROC curve analysis was used to evaluate the values of EDV,EDSI,ESSI and El alone and in combination in the assessment of left ventricular systolic function impairment.Data were analyzed by independent-sample t test,Pearson correlation and Spearman rank correlation analyses,and Delong test.Results After IPTW,EDSI and ESSI in MI group(n=319)were higher than those in HC group(n=133;EDSI:0.66±0.09 vs 0.60±0.06;ESSI:0.59±0.11 vs 0.47±0.07;t values:8.05,14.67,both P＜0.001),and El was lower than that in HC group(0.81±0.06 vs 0.85±0.03;t=-8.93,P＜0.001).In both groups,there were significant correlations between EDSI and ESSI(r values:0.928,0.873),between EDSI,ESSI and El(r values:from-0.831 to-0.641),between EDSI,ESSI and LVEF(r values:from-0.627 to-0.201),between ESSI and EDV,ESV and SMS(rs values:0.336-0.584),between ESSI and-PER,PFR(rs values:from-0.406 to-0.402,r values:from-0.352 to-0.325)(all P＜0.01).ROC curve analysis showed that EDV(AUC:0.895)and ESSI(AUC:0.839)had the highest efficacy in evaluating left ventricular systolic function impairment in MI group and HC group,respectively.EDV-EDSI-ESSI-(1-EI)had higher efficacy in the assessment of impaired left ventricular systolic function in MI group(AUC:0.956),which was higher than that of EDV or EDV-EDSI or EDV-ESSI or EDV-(1-EI)(z val-ues:from-2.64 to-2.18,P values:0.008-0.029);EDV-EDSI-ESSI-(1-EI)also had high effiicacy in HC group(AUC:0.911),which was higher than that of EDV or EDV-EDSI or EDV-(1-EI)(z values:from-2.60 to-2.43,P values:0.009-0.015).Conclusions In MI patients,the increase of SI and the decrease of El indicate the increase of left ventricular sphericity and the aggravation of left ventricular re-modeling.SI and El have certain clinical application values in evaluating left ventricular morphology,pre-dicting left ventricular remodeling and left ventricular systolic function impairment.
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维普
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