经胸冠状动脉血流显像技术对急性心肌梗死经皮冠状动脉介入术后左室重构的预测价值

目的 探讨经胸冠状动脉血流显像技术对急性心肌梗死经皮冠状动脉介入（PCI）术后早期预测左室重构的价值.方法 急性心肌梗死患者行PCI术后成功再通前降支（LAD）患者39例,术后24～48 h采用经胸冠状动脉血流显像技术获取前降支血流频谱,测量舒张期减度时间（DDT）、左心室收缩末期容积（LVESV）、左室舒张末期容积（LVEDV）和射血分数（EF）,并计算室壁运动记分指数（WMSI）.根据术后6个月LVEDV增加百分比分为重构组（≥20%）和非重构组（＜20%）.分析各参数与术后6个月LVEDV增加百分比的相关性.结果 DDT与LVEDV增加百分比呈负相关（r=-0.524,P＜0.05）.以DDT≤327 ms为截断值,预测左室重构的敏感性为76.9%,特异性为76.0%.结论 经胸冠状动脉血流显像技术对急性心肌梗死成功行PCI术后早期左室重构具有一定预测价值

Value of transthoracic coronary flow Doppler imaging in predicting left ventricular remodeling after percutaneous coronary intervention in patients with acute myocardial infarction

Objective To investigate the value of transthoracic coronary flow Doppler imaging in predicting early left ventricular remodeling after percutaneous coronary intervention （PCI） in patients with acute myocardial infarction. Methods Thirty- nine patients with acute myocardial infarction who underwent successful PCI in left anterior descending coronary artery were enrolled in this study. Coronary flow velocity in descending coronary artery was recorded by transthoracic coronary flow Doppler imaging within 24 -48 h after PCI, and diastolic deceleration time （DDT）, left ventricular end systolic volume （LYESV） , left ventricular end - diastolic volume （LVEDV） and ejection fraction （EF） were measured, the left ventricular wall motion score index （ WMSI ） was calculated. The patients were divided into the remodeling group （ ≥ 20% ） and the noremodeling group （ 〈 20% ） , then the relationship between each parameter and percentage increase in LVEDV were analyzed. Results There was negative correlation between DDT and percentage increase in LVEDV （ r = - 0. 524, P 〈 0.05 ）. When considering DDT ≤327 ms as cut off value, the sensitivity and specificity for predicting left ventricular remodeling were 76.9% and 76.0% , respectively. Conclusion Transthoracie coronary flow Doppler imaging has significant value in predicting early left ventricular remodling after PCI in patients with acute myocardial infarction.