左心室压力-应变环参数在冠心病经皮冠状动脉介入围手术期心肌做功评估中的价值  

The value of left ventricular pressure-strain loop parameters in perioperative myocardial work assessment of coronary heart disease after percutaneous coronary intervention

作　　者：赵甲彧 刘雅婷 张芳[2] 陈皓 张伟[3] 马利祥[1] ZHAO Jiayu;LIU Yating;ZHANG Fang;CHEN Hao;ZHAN Wei;MA Lixiang(Department of Cardiovascular Medicine Qinhuangdao First Hospital,Qinhuangdao Hebei 066000,China)

机构地区：[1]秦皇岛市第一医院心血管内科,河北秦皇岛066000 [2]秦皇岛市第一医院超声科,河北秦皇岛066000 [3]秦皇岛市第一医院导管室,河北秦皇岛066000

出　　处：《中国急救复苏与灾害医学杂志》2025年第2期150-154,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：秦皇岛市科学技术研究与发展计划(编号:202301A180)。

摘　　要：目的探讨左心室压力-应变环(LV-PSL)参数在冠心病经皮冠状动脉介入术(PCI)围手术期心肌做功评估中的价值。方法前瞻性选取2021年1月—2023年9月秦皇岛市第一医院收治的行PCI治疗的冠心病患者作为观察组,同期入院健康检查者100例作为对照组。应用LV-PSL评估心肌做功。比较两组的LV-PSL差异,采用受试者工作特征(ROC)曲线分析LV-PSL在冠心病PCI预后诊断中的效能。结果观察组103例,对照组100例,观察组的基线舒张末期左心室容积(LVEDV)、舒张末期左心室内径(LVEDD)、收缩末期左心室容积(LVESV)、左房前后径(LAD)、舒张末期室间隔厚度(IVSd)、左室整体纵向应变(GLS)、整体无用功(GWW)高于对照组,左室射血分数(LVEF)、整体做功效率(GWE)、整体做功指数(GWI)、整体有用功(GCW)均低于对照组(P<0.05)。观察组PCI术后1个月的LVEDV、LVEDD、LVESV、LAD、GLS、GWW低于PCI术前、PCI术后1周,LVEF、GWE、GWI、GCW高于PCI术前、PCI术后1周(P<0.05)。103例冠心病PCI术后患者,术后1个月预后良好82例(79.61%)、预后不良21例(20.39%),预后不良组的LVEDV、LVEDD、LVESV、LAD、GLS、GWW高于预后良好组,LVEF、GWE、GWI、GCW低于预后良好组(P<0.05)。LV-PSL测量参数联合预测冠心病PCI预后不良的曲线下面积AUC 0.821(0.731~0.911)高于单一指标(P<0.05)。结论LV-PSL参数能较好评估冠心病患者PCI围手术期的心肌做功情况,能为PCI术后心功能康复预测提供参考。Objective To investigate the value of left ventricular pressure-strain loop(LV-PSL)parameters in the evaluation of myocardial work during percutaneous coronary intervention(PCI).Methods Coronary heart disease patients admitted to the First Hospital of Qinhuangdao City from January 2021 to September 2023 were prospectively selected as the observation group,and 100 patients admitted for health examination during the same period were selected as the control group.Myocardial work was assessed by LV-PSL.The difference of LV-PSL between the two groups was compared,and the efficacy of LV-PSL in the prognosis of coronary heart disease PCI was analyzed by receiver operating characteristic(ROC)curve.Results There were 103 cases in the observation group and 100 cases in the control group.The baseline end-diastolic left ventricular volume(LVEDV),end-systolic left ventricular volume(LVESV),left atrial anteroposterior diameter(LAD),end-diastolic interventricular septum thickness(IVSd),global longitudinal strain(GLS)and global useless work(GWW)in the observation group were higher than those in the control group(P<0.05).In the observation group,LVEDV,LVEDD,LVESV,LAD,GLS and GWW 1 month after PCI were lower than those before and 1 week after PCI,while LVEF,GWE,GWI and GCW were higher than those before and 1 week after PCI(P<0.05).Among the 103 patients with coronary heart disease after PCI,82 cases(79.61%)had a good prognosis and 21 cases(20.39%)had a poor prognosis.LVEDV,LVEDD,LVESV,LAD,GLS and GWW in the poor prognosis group were higher than those in the good prognosis group.LVEF,GWE,GWI and GCW were lower than those in good prognosis group(P<0.05).The area under the curve AUC 0.821(0.731-0.911)of combined LV-PSL measurement parameters in predicting poor prognosis of coronary heart disease was higher than that of single index(P<0.05).Conclusion LV-PSL parameters can effectively evaluate myocardial work in patients with coronary heart disease during the perioperative period of PCI and can provide reference for predicting post-PC

关 键 词：冠心病 经皮冠状动脉介入术 左室压力-应变环 心肌功能 预后 

分 类 号：R541.4[医药卫生—心血管疾病]