多模态超声心动图评估急性心肌梗死患者PCI术后心肌功能及灌注变化  

Multimodal Echocardiography Assessing the Myocardial Function and Perfusion Alterations in Patients with Acute Myocardial Infarction Treated with Percutaneous Coronary Intervention

作　　者：赵熙璇 湛武逸 王令谆 何安霞 Zhao Xixuan;Zhan Wuyi;Wang Lingzhun;He Anxia(Department of Functional Examination,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029.China;Department of Cardiology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029.China)

机构地区：[1]南京中医药大学附属医院功能检查科,南京市210029 [2]南京中医药大学附属医院心血管内科,南京市210029

出　　处：《中国超声医学杂志》2024年第11期1254-1257,共4页Chinese Journal of Ultrasound in Medicine

基　　金：江苏省中医院科技项目(No.Y2021ZR29)。

摘　　要：目的探讨多模态超声心动图评估急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)术后心肌功能、灌注改善的应用价值。方法选择因AMI接受PCI手术的患者,分别于术后1周内、术后8周行常规超声心动图、二维斑点追踪成像(STI)、心肌声学造影(MCE)检查,获取心肌功能、微循环灌注参数。共纳入92例患者,根据术后8周MCE结果,分为A组(灌注正常,31例)及B组(灌注异常,61例)。绘制受试者工作特征(ROC)曲线,分析多模态超声参数预测心肌灌注短期恢复的效能。结果所有患者术后8周左心室射血分数(LVEF)、左心室整体纵向应变(GLS)及灌注指数(PSI)均较术后1周显著改善(P<0.05)。术后1周两组LVEF、GLS及PSI差异有统计学意义(P<0.05)。ROC曲线分析显示术后1周LVEF、GLS及PSI三者联合预测术后8周心肌微循环恢复效能较好(AUC:0.867)。结论多模态超声心动图可有效评估AMI患者PCI术后心肌功能及微循环灌注改善情况,并预测术后短期微循环障碍恢复。Objective To investigate the application value of multimodal echocardiography in assessing the improvement of myocardial function and perfusion after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods Patients who underwent PCI for AMI were selected.All patients underwent conventional echocardiography,2D speckle tracking imaging(STI),and myocardial contrast echocardiography(MCE)within 1 week and 8 weeks after the operation to obtain parameters of myocardial function and microcirculation perfusion.A total of 92 patients were selected and divided into group A[31 cases with normal perfusion score index(PSI)]and group B(61 cases with abnormal PSI)based on MCE results at 8 weeks after the operation.The receiver operating characteristic(ROC)curve was plotted to analyze the efficacy of multimodal echocardiography parameters in predicting myocardial perfusion recovery.Results LVEF,GLS and PSI were significantly improved in all patients at 8 weeks after surgery compared with 1 week after surgery(P<0.05).There were statistically significant differences in LVEF,GLS and PSI between the two groups one week after surgery(P<0.05).ROC analysis showed that the combination of LVEF,GLS and PSI at 1 week after surgery had a good predictive efficacy for myocardial microcirculation recovery at 8 weeks after surgery(AUC:0.867).Conclusions Multimodal echocardiography can effectively evaluate the improvement of myocardial function and microcirculatory perfusion in patients with AMI after PCI,and predict short-term effect on myocardial microcirculation recovery.

关 键 词：心肌声学造影 冠脉微循环 二维斑点追踪 

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