关键词:

急性ST段抬高型心肌梗死, 射血分数减少型心力衰竭, 左心室逆重构

Abstract:

Objective To explore the influential factors of left ventricular reverse remod⁃eling（LVRR）in patients with reduced ejection fraction heart failure after ST⁃segment eleva⁃tion myocardial infarction. Methods A total of 108 patients who were confirmed with STEMI and had LVEF less than 40% after primary percutaneous coronary intervention（PCI）were enrolled. According to the results of echocardiogram indicators after six months， all patients were divided into LVRR group and NLVRR group. The routine baseline and operation data collected through the electronic medical record system were compared between the two groups. The multivariate Logistic regression model was used to explore the influential factors of LVRR. The receiver operating curve（ROC curve） was used to analyze the predictive values of related factors. Results Compared with NLVRR group，the prevalence of peak NT⁃proBNP，peak cTnT，IBil，LVEDV，LVESV，TIT were lower，while FS，complete revascularization were higher in LVRR group（P < 0.05）. Regression analysis found the influential factors of LVRR were peak cTnT， TIT and complete revascularization（P < 0.05）. Peak cTnT and TIT were risk factors for LVRR，while complete revascularization was protective factor. ROC curve analysis showed the AUC of TIT combined with peak cTnT detec⁃ tion was higher than peak cTnT or TIT alone（AUC were 0.817，0.714 and 0.737，P < 0.05）. Conclusion Peak cTnT，TIT and complete revascularization were independent influential factors of LVRR in patient with HFrEF after STEMI. Peak cTnT and TIT were risk factors for LVRR，while complete revascularization was protective factor. The predictive value of peak cTnT combined with TIT for LVRR was higher than that of peak cTnT or TIT alone.

Key words:

STEMI, reduced ejection fraction heart failure, left ventricular reverse remodeling