心脏MRI参数与急性心肌梗死患者PCI术后并发心力衰竭的关系分析  

Analysis on the Relationship between Cardiac MRI Parameters and Heart Failure After PCI in Patients with Acute Myocardial Infarction

作　　者：张静 苏淑红[2] ZHANG Jing;SU Shuhong(Department of Radiology,Zhengzhou Hospital of Traditional Chinese Medicine,Zhengzhou 450000,China;Department of Cardiovascular Medicine,Xinxiang Central Hospital,Xinxiang 453001,China)

机构地区：[1]郑州市中医院放射科,河南郑州450000 [2]新乡市中心医院心血管内科,河南新乡453001

出　　处：《临床医学工程》2025年第2期195-199,共5页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20200942)。

摘　　要：目的分析心脏核磁共振成像(MRI)参数与急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后并发心力衰竭的关系。方法选取2020年1月至2022年3月在郑州市中医院行PCI术的167例AMI患者作为观察组,另招募同期医院167例健康体检者作为对照组。两组受试者均接受心脏MRI检测,收集左室功能相关参数,包括左心室射血分数(LVEF)、每搏输出量(SV)、左室质量指数(LVMI)、左室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)。随访1年统计AMI患者心力衰竭发生率,将并发心力衰竭患者纳入发生组、未并发心力衰竭患者纳入未发生组,比较发生组患者与未发生组患者的一般资料和心脏MRI参数;通过Logistic回归分析探讨AMI患者PCI术后并发心力衰竭的影响因素;采用受试者工作特征曲线(ROC)分析心脏MRI参数对AMI患者PCI术后并发心力衰竭的预测价值。结果观察组LVMI、LVESV、LVEDV、LVESD、LVEDD水平较对照组高,LVEF、SV水平较对照组低(P<0.05);AMI患者PCI术后心力衰竭发生率为14.10%(22/156),发生组患者发病至PCI时间、LVMI、LVESV、LVEDV、LVESD、LVEDD水平均较未发生组患者高(P<0.05),LVEF、SV水平较未发生组患者低(P<0.05);发病至PCI时间、LVEF、LVMI、LVESD、LVEDD均是AMI患者PCI术后并发心力衰竭的影响因素(OR=2.818、0.593、3.418、4.263、4.637,P<0.05);LVEF、LVMI、LVESD、LVEDD联合预测AMI患者PCI术后并发心力衰竭的灵敏度高于各指标单独预测(P<0.05),AUC高于各指标单独预测(P<0.05),特异度与各指标单独预测差异无统计学意义(P>0.05)。结论LVEF、LVMI、LVESD、LVEDD均是AMI患者PCI术后并发心力衰竭的影响因素,上述因素联合预测AMI患者PCI术后并发心力衰竭的效能高于各指标单独预测。Objective To explore the relationship between cardiac magnetic resonance imaging(MRI)parameters and heart failure after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).Methods 167 patients with AMI who underwent PCI in Zhengzhou Hospital of Traditional Chinese Medicine from January 2020 to March 2022 were selected as the observation group,and 167 healthy subjects in the same period were recruited as the control group.All subjects underwent cardiac MRI examination,and left ventricular function-related parameters were collected,including LVEF,SV,LVMI,LVESV,LVEDV,LVESD,LVEDD.The incidence of heart failure in AMI patients was followed up for 1 year.The patients with heart failure were included in the occurrence group,and the patients without heart failure were included in the non-occurrence group.The general data and cardiac MRI parameters of the patients in the occurrence group and the non-occurrence group were compared.Logistic regression analysis was used to explore the influencing factors of heart failure after PCI in patients with AMI.The ROC was used to analyze the predictive value of cardiac MRI parameters for heart failure after PCI in patients with AMI.Results The levels of LVMI,LVESV,LVEDV,LVESD and LVEDD in the observation group were higher than those in the control group,and the levels of LVEF and SV were lower than those in the control group(P<0.05).The incidence of heart failure after PCI in AMI patients was 14.10%(22/156).The time from onset to PCI,the levels of LVMI,LVESV,LVEDV,LVESD and LVEDD in the occurrence group were higher than those in the non-occurrence group(P<0.05),and the levels of LVEF and SV were lower than those in the non-occurrence group(P<0.05).The time from onset to PCI,LVEF,LVMI,LVESD and LVEDD were the influencing factors of heart failure after PCI in AMI patients(OR=2.818,0.593,3.418,4.263,4.637,P<0.05).The sensitivity of combining the time from onset to PCI,LVEF,LVMI,LVESD,and LVEDD to predict heart failure in AMI patients was higher than

关 键 词：核磁共振成像 急性心肌梗死 经皮冠状动脉介入治疗 心力衰竭 

分 类 号：R542.22[医药卫生—心血管疾病]