刘翠翠, 薛艳, 张雪, 徐涵. 超声心室壁应力对急性心肌梗死患者预后的预测价值[J]. 心脏杂志, 2020, 32(3): 277-281. DOI: 10.12125/j.chj.202003084
    引用本文: 刘翠翠, 薛艳, 张雪, 徐涵. 超声心室壁应力对急性心肌梗死患者预后的预测价值[J]. 心脏杂志, 2020, 32(3): 277-281. DOI: 10.12125/j.chj.202003084
    shu
    Cui-cui LIU, Yan XUE, Xue ZHANG, Han XU. Value of ultrasound ventricle end-diastolic wall stress for predicting acute myocardial infarction patients’ adverse cardiovascular outcomes[J]. Chinese Heart Journal, 2020, 32(3): 277-281. DOI: 10.12125/j.chj.202003084
    Citation: Cui-cui LIU, Yan XUE, Xue ZHANG, Han XU. Value of ultrasound ventricle end-diastolic wall stress for predicting acute myocardial infarction patients’ adverse cardiovascular outcomes[J]. Chinese Heart Journal, 2020, 32(3): 277-281. DOI: 10.12125/j.chj.202003084
    shu

    超声心室壁应力对急性心肌梗死患者预后的预测价值

    Value of ultrasound ventricle end-diastolic wall stress for predicting acute myocardial infarction patients’ adverse cardiovascular outcomes

      摘要
    • 摘要:
        目的  探讨超声心室壁应力对急性心肌梗死(AMI)患者预后的预测价值。
        方法  2017年6月~2019年8月北京市丰台中西医结合医院收治的160例AMI患者作为研究对象，患者入院后均进行经皮冠状动脉介入（PCI）治疗，PCI术后将对所有患者进行舒张末期心室壁应力、收缩末期心室壁应力、左心室射血分数（LVEF）、半乳糖凝集素-3、肌钙蛋白峰值测定。根据患者接受治疗后1年内是否发生心血管不良事件（包括心脏病死亡、复发性心肌梗死、血运重建），将患者分为非事件组（未发生主要不良心血管事件的患者）和事件组（发生主要不良心血管事件的患者），并使用ROC曲线探求分析各指标预测AMI患者预后的敏感性及特异性。
        结果  心血管不良事件发生37例（因心脏病死亡13例，复发心肌梗死14例，血运重建10例）。事件组手术后LVEF显著低于非事件组（P<0.01）；事件组手术治疗后舒张末期心室壁应力、收缩末期心室壁应力、半乳糖凝集素-3、峰值肌钙蛋白水平分别（16±3）MPa、（67±7）MPa、（18±6）μg/L和（94±11）μg/L，均高于非事件组（均P<0.01）。舒张末期心室壁应力、收缩末期心室壁应力、LVEF、半乳糖凝集素-3和峰值肌钙蛋白预测AMI患者预后情况均有较高效能。其中，舒张末期心室壁应力AUC最大，显著高于其他指标（P<0.05），其截断点（cut-off）为15.17，敏感性为94%，特异性为85%。
        结论  舒张末期心室壁应力对AMI患者心血管不良事件结局的预测具有较高的敏感性和特异性，其诊断价值值得临床借鉴。

       

      Abstract:
        AIM  To investigate the value of ultrasound ventricle end-diastolic wall stress for predicting acute myocardial infarction (AMI) patients’ adverse cardiovascular outcomes.
        METHODS  A retrospective analysis was conducted in 160 AMI cases in Beijing Fengtai Integrated Traditional Chinese and Western Medicine Hospital from June 2017 to August 2019. All the patients were treated with PCI surgery. EDWS, ESWS, LVEF, Galectin-3, and peak troponin of all patients were tested after surgery. The patients were divided into group A (without adverse cardiovascular outcomes) and group B (with adverse cardiovascular outcomes) based on adverse cardiovascular outcomes. The ROC curve was used to value the sensitivity and specificity of EDWS, ESWS, LVEF, Galectin-3, and peak troponin for predicting adverse cardiovascular outcomes. The results were compared between the two groups.
        RESULTS  There were 37 patients who had adverse cardiovascular outcomes such as cardiac mortality, recurrent MI, and revascularization. LVEF of group B was lower than that of group A (P<0.05). EDWS, ESWS, Galectin-3, and peak troponin of group B were (16±3)MPa, (67±7)MPa, (18±6)ug/L and (94±11) μg/L, which were higher than those of group A (all P<0.01). EDWS, ESWS, LVEF, Galectin-3, and peak troponin all had high efficiency for predicting adverse cardiovascular outcomes. The AUC of EDWS was the biggest and the cut-off amount was 15.17. The sensitivity of EDWS was 94.31% and the specificity was 85.38%.
        CONCLUSION  EDWS has higher efficiency to predict the adverse cardiovascular outcomes for acute myocardial infarction patients, with high sensitivity and specificity. Its diagnostic value is worthy of clinical reference.

       

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