二维超声心动图联合三维斑点追踪技术预测急性心肌梗死介入术后主要不良心血管事件的临床价值  

Clinical value of two-dimensional echocardiography combined with threedimensional speckle tracking imaging in predicting major adverse cardiovascular events after percutaneous coronary intervention in acute myocardial infarction

作　　者：忽德运 康路 王攀 HU Deyun;KANG Lu;WANG Pan(Department of Ultrasound,Huaibei People’sHospital,Anhui 235000,China)

机构地区：[1]安徽省淮北市人民医院超声科,235000 [2]安徽省淮北市人民医院心血管内科,235000

出　　处：《临床超声医学杂志》2024年第7期558-563,共6页Journal of Clinical Ultrasound in Medicine

基　　金：安徽省淮北市科技计划项目(2020HK02)。

摘　　要：目的探讨二维超声心动图联合三维斑点追踪技术(3D-STI)预测急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后主要不良心血管事件(MACE)发生的临床价值。方法选取我院收治的AMI患者98例,均于PCI术后24h内行二维超声心动图和3D-STI检查,获取左心室收缩末内径(LVESd)、左心室射血分数(LVEF)、左心室舒张末内径(LVEDd)、左心室收缩末容积(LVESV)、左心室舒张末容积(LVEDV)、旋转角度、扭转角度、整体纵向应变(GLS)、整体面积应变(GAS)、整体圆周应变(GCS)、整体径向应变(GRS)。根据PCI术后3个月内MACE发生情况分为MACE组(23例)和无MACE组(75例),比较两组上述参数的差异;分析各参数与MACE的相关性,并对MACE预警因素进行重要性排序;绘制受试者工作特征(ROC)曲线分析各参数单独及联合应用预测MACE发生的诊断效能。结果MACE组LVEF、旋转角度、扭转角度、GLS、GAS、GCS、GRS均低于无MACE组,差异均有统计学意义(均P<0.05);两组LVESd、LVEDd、LVESV、LVEDV比较,差异均无统计学意义。相关性分析显示,LVEF、旋转角度、扭转角度、GLS、GAS、GCS、GRS均与MACE呈负相关(均P<0.001);MACE预警因素的重要性排序依次为GLS、GRS、GAS、GCS、旋转角度、扭转角度、LVEF。ROC曲线分析显示,LVEF、旋转角度、扭转角度、GLS、GAS、GCS、GRS联合应用预测MACE发生的曲线下面积为0.914,均大于各参数单独应用,差异均有统计学意义(均P<0.05)。结论二维超声心动图联合3D-STI在预测AMI患者PCI术后MACE发生中有一定的临床价值,可为临床早期评估PCI术后心功能损害提供重要依据。Objective To investigate the clinical value of two-dimensional echocardiography combined with three-dimensional speckle tracking imaging(3D-STI)in predicting major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods A total of 98 patients with AMI admitted to our hospital were selected.All patients underwent two-dimensional echocardiography and 3D-STI examination within 24 h after PCI,the left ventricular end-systolic diameter(LVESd),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),rotation angle,torsion angle,global longitudinal strain(GLS),global area strain(GAS),global circumferential strain(GCS)and global radial strain(GRS)were obtained.According to the occurrence of MACE within 3 months after PCI,the patients were divided into MACE group(23 cases)and non-MACE group(75 cases).The differences of the above parameters between the two groups were compared.The correlation between each parameter and the MACE was analyzed,and the importance of MACE warning factors was ranked.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of each parameter on the occurrence of MACE.Results The LVEF,rotation angle,torsion angle,GLS,GAS,GCS and GRS in the MACE group were lower than those in the non-MACE group,and the differences were statistically significant(all P<0.05).There were no significant difference in LVESd,LVEDd,LVESV and LVEDV between the two groups.Correlation analysis showed that LVEF,rotation angle,torsion angle,GLS,GAS,GCS and GRS were negatively correlated with MACE(all P<0.001).The importance of MACE warning factors was ranked as follows:GLS,GRS,GAS,GCS,rotation angle,torsion angle and LVEF.ROC curve analysis showed that the area under the curve for predicting MACE occurrence of combined LVEF,rotation angle,torsion angle,GLS,GAS,GCS and GRS was 0.914,which was higher

关 键 词：超声心动描记术 斑点追踪 三维 心肌梗死 急性 经皮冠状动脉介入 主要不良心血管事件 预测 

分 类 号：R540.45[医药卫生—心血管疾病] R542.22[医药卫生—内科学]