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论文摘要

室壁分层分析技术评价ST段抬高心肌梗死患者的心肌运动

Layer-specific Analysis in Patients with ST Segment Elevation Myocardial Infarction

作者:黄鹤, 刘晓琴, 黄宝涛等

Author:HUANG He, LIU Xiao-qin, HUANG Bao-tao. et alY。

收稿日期:          年卷(期)页码:2016,47(5):743-748

期刊名称:四川大学学报(医学版)

Journal Name:JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION)

关键字:室壁分层分析 心肌梗死 左室重塑

Key words:Layer-specific analysis Myocardial infarction Left ventricular remodeling

基金项目:

中文摘要

目的 运用室壁分层分析技术评价ST段抬高心肌梗死(STEMI)患者左室壁三层心肌运动情况及其预测左室重塑的能力。方法 纳入成功行直接冠脉介入(P-PCI)的初次STEMI患者39例及30例正常对照。在P-PCI术后48 h内(随访前)及6个月时(随访时)行超声心动图检查。分析三维心功能及室壁长轴及圆周内、中、外三层应变。结果 ① STEMI患者随访前室壁长轴内层应变高于外层(P P P P P P P =0.03),其预测左室重塑切点值为-9%(敏感度89.5%,特异度70.2%)。结论 P-PCI术后48 h内STEMI患者室壁应变从内层向外层减低,左室重塑组心肌功能低于非重塑组,左室壁长轴外层应变可独立预测STEMI患者的左室重塑。

英文摘要

Objective To evaluate left ventricular wall function after ST segment elevation myocardial infarction(STEMI) by layer-specific analysis and determine if the layer-specific parameters can predict left ventricular remodeling(LVR). Methods Thirty nine patients with first STEMI who had successful primary percutaneous coronary intervention(P-PCI) were studied, while 30 healthy individuals were included as normal control. Echocardiographic examinations were performed in STEMI patients within 48 h after P-PCI (before follow-up) and 6 months later (follow-up). Three dimensional cardiac function and longitudinal, circumferential 3-layer strain were analyzed. Results In STEMI, longitudinal endocardial strain was higher than epicardial strain (PPPPPP=0.03), the cut off value of -9% yielded 89.5% sensitivity and 70.2% specificity. Conclusion Strain decreased from endocardium to epicardium within 48 h after P-PCI in STEMI. Myocardial function was lower in LVR group. Longitudinal epicardial strain could be employed as an independent predictor of LVR after STEMI.

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