无创左室压力-应变环评估急性心肌梗死患者经皮冠状动脉介入术前后左心功能及左室重构的价值

doi:10.3969/j.issn.1006-5725.2024.20.005

Abstract

Abstract:

Objective To explore the clinical value of noninvasive left ventricular pressure-strain loop （LV-PSL） technique in evaluating myocardial work and left ventricular remodeling before and after percutaneous coronary intervention （PCI） in patients with acute myocardial infarction （AMI）. Methods Seventy patients with AMI admitted to our hospital （coronary heart disease group） and 50 healthy adults （control group） who underwent physical examination during the same period were selected， The conventional echocardiographic indexes， left ventricular global longitudinal strain （GLS） and left ventricular myocardial work indexes，［global work index（GWI）， global work efficiency（GWE）， global constructive work（GCW）， global wasted work （GWW）］were examined before and 7 days after operation in control group and coronary heart disease group. The differences of the above indexes between the coronary heart disease group and control groups were compared. According to the results of coronary angiography， AMI patients were further divided into a coronary heart disease single-branch group （34 cases） and a coronary heart disease multi-branch group （36 cases）， and the differences of the above indexes between the two groups were compared. Analyze the correlation between left ventricular myocardial work indexes and GLS， conventional echocardiographic indexes. Result Left ventricular end-systolic volume （LVESV）， left ventricular end-diastolic volume （LVEDV） and GWW were higher incoronary heart disease group than in control group before and 7 days after surgery， while left ventricular ejection fraction （LVEF）， GWI， GWE， GCW and GLS were lower than control group， with statistical significance （all P < 0.05）. At 7 days after surgery， LVESV， LVEDV and GWW in the coronary heart disease group were lower than those before surgery， while LVEF， GWI， GWE， GCW and GLS were higher than those before surgery， with statistical significance （all P < 0.05）. LVESV， LVEDV and GWW at 7 days before and after surgery in the coronary heart disease multi-branch group were higher than those in the coronary heart disease single-branch group， while LVEF， GWI， GWE， GCW and GLS were lower than those in the coronary heart disease single-branch group， with statistical significance （all P < 0.05）. Correlation analysis showed that GWW was negatively correlated with GLS and LVEF， while GWE， GCW and GWI were positively correlated with GLS and LVEF （all P < 0.001）. Conclusion LV-PSL technique has good application value in evaluating left ventricular function and left ventricular remodeling in AMI patients before and after PCI， and provides a new non-invasive method　for clinical practice.

Key words: myocardial work, acute myocardial infarction, left heart function, left ventricular remodeling

CLC Number:

R541.4

Xinhe WANG,Chuangwen YE,Huasheng TONG,Fei MENG,Xiansheng ZHU. The value of noninvasive left ventricular pressure⁃strain loop in evaluating left ventricular function and left ventricular remodeling before and after percutaneous coronary artery intervention in patients with acute myocardial infarction[J]. The Journal of Practical Medicine, 2024, 40(20): 2841-2847.

Figures/Tables 9

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References 21

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组别	性别/例		年龄/岁	心率/（次/min）	收缩压/mmHg	舒张压/mmHg
组别	男	女	年龄/岁	心率/（次/min）	收缩压/mmHg	舒张压/mmHg
对照组	30	20	53.9 ± 6.3	72.24 ± 23.62	120.04 ± 3.39	74.30 ± 2.71
冠心病组	42	28	54.5 ± 6.0	73.59 ± 4.18	121.39 ± 3.28	75.52 ± 2.71
t/χ²值	0.322		-0.520	-1.424	-1.774	-1.917
P值	0.748		0.604	0.157	0.079	0.058

组别	LVEDV/mL	LVESV/mL	LVEF/%
对照组	91.32 ± 8.85	44.54 ± 7.25	61.42 ± 3.62
冠心病组
术前	108.51 ± 5.66^*	50.46 ± 4.21^*	52.46 ± 5.98^*
术后7 d	102.56 ± 7.19^*#	46.50 ± 3.73^*#	56.59 ± 3.74^*#
F值	84.491	21.976	53.766
P值	< 0.001	< 0.001	< 0.001

组别	GWI/（mmHg/%）	GCW/（mmHg/%）	GWW/（mmHg/%）	GWE/%	GLS/%
对照组	1 956.78 ± 125.24	2 261.88 ± 171.82	54 ± 18.05	97.28 ± 0.97	21.32 ± 2.03
冠心病组
术前	1 731.13 ± 214.62^?	1 975.96 ± 203.04^?	133.80 ± 41.93^?	93.19 ± 2.57^?	17.74 ± 1.89^?
术后7 d	1 845.73 ± 200.01^?#	2 081.97 ± 200.90^?#	97.24 ± 40.15^?#	95.13 ± 2.23^?#	18.66 ± 1.74^?#
F值	20.915	31.608	70.060	54.535	55.117
P值	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

组别	LVEDV/mL	LVESV/mL	LVEF/%
冠心病单支组
术前	106.06 ± 4.55	49.09 ± 4.17	56.09 ± 4.31
术后7 d	97.59 ± 4.52^?	46.12 ± 3.86^?	57.35 ± 3.37^?
冠心病多支组
术前	110.83 ± 5.68^#	51.75 ± 3.89^#	49.03 ± 5.29^#
术后7 d	107.25 ± 6.00^?#	46.86 ± 3.62^?#	55.86 ± 3.98^?#

组别	GWI/（mmHg/%）	GCW/（mmHg/%）	GWW/（mmHg/%）	GWE/%	GLS/%
冠心病单支组
术前	1 866.79 ± 187.51	2 080.58 ± 185.49	114.30 ± 35.94	94.52 ± 2.14	18.12 ± 1.83
术后7 d	1 968.12 ± 177.33	2 185.36 ± 183.60	69.697 ± 26.59	96.7 ± 1.29	19.09 ± 1.68
冠心病多支组
术前	1 610.14 ± 158.48	1 882.65 ± 171.00	151.19 ± 39.52	92 ± 2.31	17.41 ± 1.89
术后7 d	1 736.57 ± 150.82^?#	1 989.76 ± 169.87^?#	121.81 ± 33.85^?#	93.73 ± 1.94^?#	18.27 ± 1.72^?#

The value of noninvasive left ventricular pressure⁃strain loop in evaluating left ventricular function and left ventricular remodeling before and after percutaneous coronary artery intervention in patients with acute myocardial infarction

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心肌做功参数	LVEF		GLS
心肌做功参数	r值	P值	r值	P值
GWI	0.49	< 0.001	0.73	< 0.001
GCW	0.45	< 0.001	0.78	< 0.001
GWE	0.51	< 0.001	0.70	< 0.001
GWW	-0.52	< 0.001	-0.71	< 0.001

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