二維斑點(diǎn)追蹤成像預(yù)測急性心肌梗死介入治療后左室重構(gòu)的研究

摘要： 目的探討超聲二維斑點(diǎn)追蹤成像(STE)預(yù)測急性心肌梗死(AMI)冠脈支架植入術(shù)(PCI)后左室重構(gòu)的價(jià)值。方法 53例因AMI行急診PCI術(shù)的患者在術(shù)后72 h行STE檢查,檢測左室心肌峰值徑向應(yīng)變(RS)、圓周應(yīng)變(CS)、縱向應(yīng)變(LS)和峰值應(yīng)變延長時(shí)間(TPS)。并在術(shù)后6個(gè)月檢測左室舒張末容積(LVEDV)的變化,以LVEDV增大≥15%作為左室重構(gòu)的標(biāo)準(zhǔn)。結(jié)果隨訪時(shí)出現(xiàn)左室重構(gòu)的11例患者(21%)在術(shù)后72 h的RS,CS和LS均顯著低于沒有左室重構(gòu)的患者,TPS則延長(P<0.001)。減低的LS是最有力的獨(dú)立預(yù)測左室重構(gòu)的危險(xiǎn)因子,LS≤-11.4%預(yù)測的敏感性和特異性分別是89.4%和81.2%。結(jié)論 STE能夠準(zhǔn)確預(yù)測AMI經(jīng)PCI治療后左室重構(gòu)。
Objective To test whether two-dimensional speckle tracking echocardiography (STE) is a useful technique for predicting left ventricular (LV) remodeling in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods In 53 patient with AMI after PCI, the peak radial (RS), circumferential (CS), and longitudinal (LS) strain were measured at LV myocardium at 72 hours. LV remodeling was defined as an increase of 15% of LV end-diastolic volume (LVEDV) from 72 hours to 6 months. Results 11 patients had developed LV remodeling (21%), and the RS, CS, and LS were lower in patients with LV remodeling. The major determinants of LV remodeling was RS and LS, and a LS≤-11.4% prognosticated LV remodeling with 89.4% sensitivity and 81.2 % specificity. Conclusions STE is useful in predicting LV remodeling.