CMR评价急性心肌梗死PCI后远程心肌应变影响因素  

Influencing Factors of Remote Myocardial Strain after PCI in Acute Myocardial Infarction Evaluated by CMR

作　　者：顿雨桐 牛惜情 李国策[2] 张厚宁 张斌[4] 潘志斌 边浩 康立清[2] 刘凤海 DUN Yu-tong;NIU Xi-qing;LI Guo-ce;ZHANG Hou-ning;ZHANG Bin;PAN Zhi-bin;BIAN Hao;KANG Li-qing;LIU Feng-hai(Department of Magnetic Resonance Imaging,Hebei Medical University Affiliated Cangzhou Central Hospital,Cangzhou 061000,Hebei Province,China;Department of Magnetic Resonance Imaging,Cangzhou Central Hospital,Cangzhou 061000,Hebei Province,China;Department of Magnetic Resonance Imaging,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,Hebei Province,China;Department of Medical Imaging,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei Province,China)

机构地区：[1]河北医科大学附属沧州市中心医院磁共振成像科,河北沧州061000 [2]沧州市中心医院磁共振成像科,河北沧州061000 [3]华北理工大学附属医院磁共振室,河北唐山063000 [4]河北北方学院附属第一医院医学影像部,河北张家口075000

出　　处：《中国CT和MRI杂志》2025年第1期85-88,共4页Chinese Journal of CT and MRI

基　　金：河北省2024年度医学科学研究课题(20241752)。

摘　　要：目的 采用心脏磁共振特征追踪技术(CMRFT)评价急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后远程心肌(RM)的收缩功能,并探讨远程心肌收缩功能的影响因素。方法回顾性分析141例因AMI行急诊P CI治疗患者RM的C MR应变参数,比较RM应变受损组和RM应变保留组间临床及影像参数的差异。采用多因素Logistic回归分析确定RM收缩功能的影响因素。结果 141例患者共识别423个RM节段,其中54例、102个RM节段周向应变受损。两组间年龄(P=0.035)、高脂血症史(P=0.049)及罪犯血管(P<0.001)的差异有统计学意义。多因素Logisti c回归分析显示,年龄增高是RM周向应变受损的独立保护因素,高脂血症史是RM周向应变受损的独立危险因素。罪犯血管为回旋支及右冠状动脉患者发生RM周向应变受损的风险高于左前降支者,差异有统计学意义。结论AMI后RM收缩功能存在受损风险,高脂血症史、罪犯血管、年龄是RM收缩功能的影响因素。Objective This study aimed to quantify the contractile function of remote myocardium(RM)after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)by cardiac magnetic resonance feature tracking(CMR-FT),and to explore the influencing factors of remote myocardial contractility.Methods A retrospective analysis of clinical and imaging data of141 patients undergoing primary PCI treatment for AMI was performed.Subjects were divided into the RM strain impaired group and the RM strain preserved group.Multivariate logistic regression analysis was used to determine the influencing factors of RM contractile function.Results A total of 423 RM segments were identified in 141 patients,of which 54 patients and 102 RM segments had impaired circumferential strain.There were significant differences in age(P=0.035),history of hyperlipidemia(P=0.049),a nd culprit vessel(P<0.001)between groups.M ultivariate logistic regression analysis showed that increasing age reduced the risk of RM circumferential strain impairment,and history of hyperlipidemia increased the risk of RM circumferential strain impairment.The risk of RM circumferential strain impaired was higher in the patients with left circumflex a rtery and right coronary artery infarction than those with left anterior descending artery infarction.Conclusion There is a risk of impaired RM systolic function after AMI,and the history of hyperlipidemia,culprit vessel,and age a re the influencing factors of fa r RM systolic function.

关 键 词：急性心肌梗死 远程心肌 心脏磁共振成像 特征追踪 

分 类 号：R445.2[医药卫生—影像医学与核医学]