Abstract
[Objective]To explore the predictive value of three-dimensional cardiac ultrasound parameters combined with blood uric acid(UA)and apolipoprotein A1/apolipoprotein B(ApoA1/ApoB)for heart failure after percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI).[Methods]A total of 107 patients with AMI who underwent PCI in our hospital from June 2020 to January 2022 were selected as AMI group,and 107 healthy volunteers were recruited as control group.The cardiac function of subjects in 2 groups was evaluated and compared by three-dimensional cardiac ultrasound,including left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF).UA,ApoA1 and ApoB levels in peripheral blood of subjects in 2 groups were detected,and ApoA1/ApoB were calculated.After 1-year follow-up,the incidence of heart failure after PCI in patients in the AMI group was calculated.Three-dimensional cardiac ultrasound parameters and peripheral blood UA,ApoA1/ApoB levels between patients with and without heart failure after PCI in the AMI group.Logistic regression analysis was used to investigate the influencing factors of heart failure after PCI in AMI group.Receiver operating characteristic(ROC)curve was drawn to analyze three-dimensional cardiac ultrasound parameters,and the value of peripheral blood UA,ApoA1/ApoB levels alone and in combination for predicting heart failure in AMI patients after PCI.[Results]LVESV,LVEDV,LVESD,LVEDD,and serum UA in AMI group were higher than those in control group(P＜0.05),while LVEF and serum ApoA1/ApoB were lower than those in control group(P＜0.05).The incidence of heart failure in AMI patients was 28.28％.The time from onset to PCI in patients with heart failure was longer than that in patients without heart failure(P＜0.05),the proportion of Gensini score＞60,LVESV,LVEDV and serum UA were higher than those without heart failure(P＜0.05),and LVEF and serum ApoA1/ApoB were lower than those without heart failure(P＜0.05).The time from onset to PCI,Gensini score,LVESD,LVEDD,LVESV,LVEDV,LVEF,UA,ApoA1/ApoB were all the influencing factors of heart failure after PCI in AMI patients((O^R))=3.127,2.833,3.327,3.554,0.596,3.056,0.575,P＜0.05).The sensitivity of three-dimensional cardiac ultrasound parameters LVESD,LVEDD,LVEF,serum UA,ApoA1/ApoB in combination with the prediction of AMI patients complicated with heart failure after PCI was higher than that predicted alone(P＜0.05),and the area under curve(AUC)was higher than that of single prediction(P＜0.05).There was no significant difference in specificity between combined predition and single prediction(P＞0.05).[Conclusion]Three-dimensional echocardiography parameters,serum UA and ApoA1/ApoB levels are all factors affecting heart failure after PCI in AMI patients.The combined prediction of the three factors is more effective than the single prediction in predicting heart failure after PCI in AMI patients.关键词
急性心肌梗死/心力衰竭/三维心脏超声/尿酸/载脂蛋白A1/载脂蛋白B/经皮冠脉介入术Key words
acute myocardial infarction/heart failure three-dimensional cardiac ultrasound/uric acid/apolipoprotein A1/apolipoprotein B/percutaneous coronary intervention分类
医药卫生
