ST段抬高型心肌梗死患者心肌节段做功指数与磁共振透壁增强的相关性  

Correlation between myocardial segmental work index and magnetic resonance transmural enhancement in patients with ST-segment elevation myocardial infarction

作　　者：侯淑红 李章静 孙林林 林勇 陈丽玲 陈东平 HOU Shuhong;LI Zhangjing;SUN Linlin;LIN Yong;CHEN Liling;CHEN Dongping(Department of Medical Imaging,the First Affiliated Longyan Hospital of Fujian Medical University,Fujian 364000,China)

机构地区：[1]福建医科大学附属龙岩第一医院医学影像科,福建省龙岩市364000 [2]福建医科大学附属龙岩第一医院心血管内科,福建省龙岩市364000

出　　处：《临床超声医学杂志》2022年第8期593-597,共5页Journal of Clinical Ultrasound in Medicine

基　　金：龙岩市科技计划联合资金项目(2021LYF17037)。

摘　　要：目的应用左室压力-应变环(PSL)评估经皮冠状动脉介入治疗(PCI)的ST段抬高型心肌梗死(STEMI)患者心肌节段做功指数,探讨其与磁共振透壁增强的相关性。方法选取我院行PCI的STEMI患者61例,应用左室PSL获得心肌节段做功指数(WIs)、心肌节段有效做功(CWs)、心肌节段无效做功(WWs)和心肌节段做功效率(WEs),同时应用磁共振钆延迟增强扫描(LGE-CMR)检测各心肌节段透壁增强程度,比较不同透壁增强心肌节段做功指数,分析心肌节段做功指数与透壁增强的相关性;比较心肌梗死核心区与远离区心肌做功指数的差异。结果1037个心肌节段中,124个(11.96%)心肌节段为透壁增强,425个(40.98%)为非透壁增强,488个(47.06%)为无增强。非透壁增强、透壁增强心肌节段WIs、CWs和WEs均降低,WWs增加,与无增强心肌节段比较差异均有统计学意义(均P<0.05)。WIs、CWs和WEs与LGE-CMR透壁增强均呈负相关(r=-0.666、-0.848、-0.365,均P<0.05),WWs与透壁增强呈正相关(r=0.841,P<0.05)。心肌梗死核心区心肌节段WIs、CWs和WEs均降低,WWs增加,与心肌梗死远离区比较差异均有统计学意义(均P<0.05)。结论应用左室PSL可以准确评估PCI治疗的STEMI患者心肌节段做功指数,且其与LGE-CMR透壁增强相关。Objective To evaluate myocardial segmental work index in patients with ST-segment elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI)by left ventricular pressure-strain loop(PSL),and to explore its correlation with magnetic resonance transmural enhancement.Methods A total of 61 STEMI patients who underwent PCI in our hospital were selected.Myocardial segmental work index(WIs),myocardial segmental effective work(CWs),myocardial segmental ineffective work(WWs),and myocardial segment work efficiency(WEs)were obtained by left ventricular PSL.At the same time,the degree of transmural enhancement of each cardiac segment was examined by late gadolinium contrast enhanced cardiac magnetic resonance(LGE-CMR),and the work index of different myocardial segments with transmural enhancement was compared.Furthermore,the correlation between myocardial work index and transmural enhancement were analyzed,and the differences in myocardial work between the core zone and the remote zone of myocardial infarction were compared.Results Among the 1037 myocardial segments,124(11.96%)segments were transmural enhancement,425(40.98%)segments were non-transmural enhancement,and 488(47.06%)segments were no enhancement.WIs,CWs and WEs decreased significantly and WWs increased significantly in the non-transmural enhancement and transmural enhancement myocardium segments,the differences were statistically significant compared with noenhanced myocardium segments(all P<0.05).WIs,CWs and WEs were negatively correlated with LEG-CMR transmural enhancement(r=-0.666,-0.848,-0.365,all P<0.05),and WWs was positively correlated with transmural enhancement(r=0.841,P<0.05).Compared with the remote zone,WIs,CWs and WEs of the core zone decreased significantly,and WWs increased significantly(all P<0.05).Conclusion The application of left ventricular PSL can accurately assess myocardial segmental work index in STEMI patients treated by PCI,and it is correlated with the transmural enhancement of LGE-CMR.

关 键 词：超声心动描记术 左室压力-应变环 心肌做功 心脏磁共振 心肌梗死 

分 类 号：R540.45[医药卫生—心血管疾病] R542.2[医药卫生—内科学]