CMR心肌应变联合心肌酶对急性心肌梗死治疗后左心室射血分数正常患者微血管阻塞的预测价值  

The Predictive Value of CMR Myocardial Strain Combined with Myocardial Enzyme Formicrovascular Obstruction in Patients with Normal Left Ventricular Ejection Fraction after Treatment for Acute Myocardial Infarction

作　　者：张子倩 尹宏斌 刘苏宁 周莹 ZHANG Ziqian;YIN Hongbin;LIU Suning(The Affiliated Lianyungang Hospital of Xuzhou Medical University,Lianyungang,Jiangsu Province 222000,P.R.China)

机构地区：[1]徐州医科大学附属连云港医院,连云港222000 [2]锦州医科大学连云港临床学院,连云港222000

出　　处：《临床放射学杂志》2024年第10期1708-1713,共6页Journal of Clinical Radiology

基　　金：中华国际医学交流基金会SKY影像科研基金项目(编号:Z-2014-07-2101);连云港市卫计委面上项目(编号:202007)。

摘　　要：目的探讨心脏磁共振成像(CMR)心肌应变联合心肌酶对急性ST段抬高型心肌梗死(STEMI)经皮冠状动脉术后(PCI)左心室射血分数(LVEF)正常患者微血管阻塞(MVO)的预测价值。方法回顾性分析2021年9月至2023年7月首次接受直接PCI治疗和CMR检查的急性STEMI患者,治疗后LVEF正常者共计72例,其中MVO组27例,非MVO组45例。对比分析两组间临床资料、左心室整体短轴径向应变(GRSSAX)、整体长轴径向应变(GRSLAX)、整体周向应变(GCS)、整体纵向应变(GLS)及梗死节段与远端心肌的节段应变差异。结果术前磷酸肌酸激酶升高、术前肌酸激酶同工酶升高、GRSSAX降低是急性STEMI治疗后并发MVO的预测因子。在MVO组中,梗死节段与远端心肌的节段短轴径向应变(SPCSSAX)、节段长轴径向应变(SPCSLAX)、节段周向应变(SPRS)存在显著差异(P<0.05),在非MVO组中,梗死节段与远端心肌的SPCSSAX、SPCSLAX、SPRS、SPLS存在显著差异(P<0.05)。结论CMR心肌应变联合心肌酶对急性STEMI患者PCI治疗后LVEF正常的患者并发MVO有一定的预测价值。Objective To investigate the predictive value of cardiac magnetic resonance imaging(CMR)myocardial strain combined with myocardial enzyme formicrovascular obstruction(MVO)in patients with normal left ventricular ejection fraction(LVEF)after percutaneous coronary intervention(PCI)and acute ST-segment myocardial infarction(STEMI).Methods A total of 72 patients with acute STEMI who received primary PCI and CMR for the first time from September 2021 to July 2023 were retrospectively analyzed,including 27 in the MVO group and 45 in the non-MVO group.The clinical data,the overall short-axis radial strain,long-axis radial strain,circumferential strain,longitudinal strain,and segmental strain differences between the two groups were compared and analyzed.Results Elevated preoperative Creatine Kinase(CK),Creatine Kinase isoenzymes(CK-MB)and decreasedglobal radial strain(GRS)were predictors for MVO in patients with normal LVEF after PCI treatment in patients with acute STEMI.In the MVO group,there were significant differences in radial strain on the short-axis,radial strain on the long-axis,and circumferential strain of the infarct segment and the distal myocardium(P<0.05),and in the non-MVO group,there were significant differences in radial strain on the short-axis,radial strain on the long-axis,circumferential strain andlongitudinal strain of the infarct segment and the distal myocardium(P<0.05).Conclusion The myocardial strain of CMR combined with myocardial enzyme has certain predictive value for MVO in patients with normal LVEF after PCI treatment in patients with acute STEMI.

关 键 词：ST段抬高型心肌梗死 心脏磁共振成像 心肌应变 微血管阻塞 心肌酶 

分 类 号：R542.22[医药卫生—心血管疾病]