左室射血分数正常的ST段抬高型心肌梗死患者左心房心肌应变特征  

Assessment of left atrial myocardial strain in STEMI patients with preserved left ventricular ejection fraction

作　　者：马英杰 田静 王鹏 李阳 徐静 王建 王强 李彬 MA Yingjie;TIAN Jing;WANG Peng;LI Yang;XU Jing;WANG Jian;WANG Qiang;LI Bin(Department of Cardiology,Central Hospital Affiliated to Shandong First Medical University,Jinan 250013;Department of Radiology,Central Hospital Affiliated to Shandong First Medical University,Jinan 250013,China)

机构地区：[1]山东第一医科大学附属中心医院心血管内科,济南250013 [2]山东第一医科大学附属中心医院放射科,济南250013

出　　处：《国际心血管病杂志》2023年第5期326-329,335,共5页International Journal of Cardiovascular Disease

基　　金：山东省自然科学基金(ZR2020MH026);济南市临床医学科技创新计划(202019045);中国博士后科学基金(2020M682119);山东省博士后创新项目(202102041)。

摘　　要：目的:通过心脏磁共振特征追踪(CMR-FT)技术定量评估左室射血分数(LVEF)正常的ST段抬高型心肌梗死(STEMI)患者左心房功能。方法:选取2020年1月至2022年6月山东第一医科大学附属中心医院32例STEMI患者为STEMI组,心脏彩色多普勒超声示LVEF≥50%。同期20名健康志愿者为对照组。2组均行超声心动图和心脏磁共振(CMR)检查,应用CMR-FT技术比较2组CMR的左心房、左心室特征。结果:STEMI组患者的LVEF较对照组明显降低,而左室舒张末期容积、左室收缩末期容积较对照组升高。2组间左房总射血分数、总应变、被动射血分数、被动应变率的差异有统计学意义(P<0.05),而2组间左房主动射血分数、被动应变、主动应变、总应变率、主动应变率的差异无统计学意义(P>0.05)。STEMI组患者的左房总射血分数与总应变、被动射血分数与被动应变、主动射血分数与主动应变均呈正相关(r=0.469、0.661、0.492,P<0.01)。结论:CMR-FT技术可客观评估LVEF正常的STEMI患者左心房功能,具有较高的临床应用价值。Objective:To quantitatively assess left atrial function in patients with ST-segment elevation myocardial infarction(STEMI)and normal ejection fraction by cardiac magnetic resonance-feature tracking(CMR-FT)technique.Methods:32 patients with STEMI admitted to Central Hospital of Shandong First Medical University from January 2020 to June 2022 were included.All patients had an echocardiographic left ventricular ejection fraction(LVEF)of≥50%.Teventty healthy volunteers were served as controls.Two-dimensional echocardiography and cardiac magnetic resonance(CMR)were performed,and left atrial and ventricular characteristics derived from CMR-FT technique were compared between the two groups.Results:Compared with healthy controls,STEMI patients with normal LVEF had significantly lower LVEF and larger left ventricular end-diastolic and end-systolic volumes.Left atrialtotal ejection fraction,total strain,passive ejection fraction,and passive strain rate were significantly different(all P<0.05),but active ejection fraction,passive strain,active strain,total strain rate,and active strain rate did not significantly differ between the two groups(all P>0.05).Moreover,in STEMI patients with normal LVEF,there was a positive correlation between total ejection fraction and total strain(r=0.469,P<0.01),between passive ejection fraction and passive strain(r=0.661,P<0.01),and betwee active ejection fraction and active strain(r=0.492,P<0.01).Conclusion:CMR-FT provides an objective assessment of left atrial function in STEMI patients with preserved LVEF.

关 键 词：ST段抬高型心肌梗死 左室射血分数 左心房功能 磁共振成像 心肌应变 

分 类 号：R542.22[医药卫生—心血管疾病]