中国临床医学影像杂志2025，Vol.36Issue(9)：653-657,662,6.DOI:10.12117/jccmi.2025.09.011
心肌声学造影对ST段抬高型心肌梗死患者经皮冠状动脉介入术后左心室功能恢复的预测价值
Predictive value of myocardial contrast echocardiology for recovery of left ventricular function after percutaneous coronary intervention in patients with ST-segment elevation myocardial infraction
摘要
Abstract
Objective:To use myocardial contrast echocardiology(MCE)parameters to predict the function of left ventricular recovery after percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STEMI).Methods:A retrospective analysis was performed in STEMI patients who underwent PCI treatment at Renmin Hospital of Wuhan University from May 2021 to November 2022.All enrolled patients underwent follow-up routine echocardiology examinations at the first week and the sixth month after PCI treatment.STEMI patients were divided into recovered and non-recovered left ventricular function according to LVEF.Qlab software was applied to obtain the MCE parameters:intensity of myocardial segmental enhancement during the plateau phase(A),mean filling rate constant(β)and microvascular blood flow(MBF).Multivariate logistic regression analysis was used to explore the relationship between variables and prognosis while a Nomogram prediction model was constructed.ROC curves were plotted to assess the predictive efficacy of the model.Results:A total of 78 patients were enrolled,including 48 patients in the left ventricular function recovery group and 30 patients in the non-recovered left ventricular function group.In the left ventricular function recovery group,A((11.21±2.76)dB vs(10.48±2.24)dB,P=0.039),β(1.28(0.87,1.60)s-1 vs 0.97(0.84,1.11)s-1,P=0.046)and MBF(11.50(10.52,15.53)dB/s vs 10.14(8.32,12.43)dB/s,P＜0.001)were higher than those in the non-recovered left ventricular function group and the differences were statistically significant.Multivariate Logistic regression analysis showed that systolic blood pressure was an independent protective factor for the recovery of left ventricular function after PCI in patients with STEMI(OR:0.978,95%CI:0.957～1.000,P=0.049)and MBF was an independent risk factor for the recovery of left ventricular function after PCI in patients with STEMI(OR:1.332,95%CI:1.062～1.670,P=0.013).The Nomogram model was constructed based on systolic blood pressure and MBF to indicate that the model's AUC was 0.78 and the sensitivity was 93.6%,specificity 56.7%.The integrated discrimination improvement(IDI)for quantitative evaluation of prognostic model prediction using conventional ultrasound combined with MCE parameters was 38%(AUC was 0.77,sensitivity was 83.0%,specificity was 73.3%).Conclusion:Perfusion information provided by MCE has great clinical value in predicting the status of left ventricular functional recovery after PCI in patients with STEMI.MBF and systolic blood pressure are independent influencing factors in predicting left ventricular functional recovery.关键词
心肌梗死/心室功能,左/经皮冠状动脉介入治疗/超声心动描记术Key words
Myocardial Infarction/Ventricular Function,Left/Percutaneous Coronary Intervention/Echocardiography分类
医药卫生引用本文复制引用
周世源,李明奇,郑赛,周青..心肌声学造影对ST段抬高型心肌梗死患者经皮冠状动脉介入术后左心室功能恢复的预测价值[J].中国临床医学影像杂志,2025,36(9):653-657,662,6.基金项目
国家自然科学基金面上项目(82271999). （82271999）
