急性心肌梗死患者行经皮冠状动脉介入治疗前后心脏磁共振成像左心功能评价的研究

目的应用心脏磁共振成像(CMR)对急性心肌梗死患者行经皮冠状动脉介入治疗(PCI)前后的左心功能进行评价,并将其结果与超声心动图结果进行比较,分析结果及其相关性。方法急性心肌梗死男性患者43例,在急性心肌梗死后7~10d内行超声心动图及CMR,10~14d内行PCI治疗。6个月后复查超声心动图及CMR。比较PCI前后急性心肌梗死患者左心功能[左室射血分数(LVEF)]的变化及2种评价方法结果的相关性。结果 PCI术后LVEF较术前有所改善,差异有统计学意义(P<0.05);CMR所测得的LVEF低于超声心动图,两者相关性较好,PCI前后其相关系数分别为(r=0.75,P<0.05;r=0.78,P<0.05)。结论①PCI对改善急性心肌梗死患者的左心功能有较为显著的效果;②CMR与超声心动图所测得LVEF值有较高的相关性;③CMR评价左心功能具有很大的临床应用价值。

Left ventricular function assessed by cardiac magnetic resonance in patients with acute myocardial infarction prior to and following percutaneous coronary intervention

Objective To evaluate the left ventricular function by using cardiac magnetic resonance （CMR） in patients with acute myocardial infarction （AMI） prior to and following pereutaneous coronary intervention （PCI） and to determine the correlation with findings of echocardiography. Methods Forty-three consecutive male patients with AMI were subjected to echocardiography and CMR at days 7-10 following the episodes, which was followed by treat- ment with PCI at days 10-14. At month 6, reassessments of echocardiography and CMR were repeated. The difference in left ventricular ejection fraction （LVEF） and the correlation with echocardiography were analyzed. Results Treat- ment with PCI resulted in a substantially higher LVEF （P〈0.05）. Though the LVEF derived from CMR was lower than that from echocardiography, the data were ideally correlated （preoperative： r=0.75, P〈0.05; postoperative： r=0.78, P〈 0.05）. Conclusion Treatment with PCI leads to significantly improved LVEF in patients with AMI. The LVEF derived from CMR correlated well with that from echocardiography. CMR may be an accurate technique for measurement of left heart function evaluation and appears clinically useful.