二维斑点追踪成像预测急性心肌梗死介入治疗后左室重构的研究

目的 探讨超声二维斑点追踪成像(STE)预测急性心肌梗死(AMI)冠脉支架植入术(PCI)后左室重构的价值.方法 53例因AMI行急诊PCI术的患者在术后72 h行STE检查,检测左室心肌峰值径向应变(RS)、圆周应变(CS)、纵向应变(LS)和峰值应变延长时间(TPS).并在术后6个月检测左室舒张末容积(LVEDV)的变化,以LVEDV增大≥15%作为左室重构的标准.结果 随访时出现左室重构的11例患者(21%)在术后72 h的RS,CS和LS均显著低于没有左室重构的患者,TPS则延长(P<0.001).减低的LS是最有力的独立预测左室重构的危险因子,LS≤-11.4%预测的敏感性和特异性分别是89.4%和81.2%.结论 STE能够准确预测AMI经PCI治疗后左室重构.

Predictive Value of Two-dimensional Speckle Tracking Echocardiography in Left Ventricular Remodeling in Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention

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.