Ohara Yoshikazu, Hiasa Yoshikazu, Hosokawa Shinobu, Suzuki Naoki, Takahashi Takefumi, Kishi Koichi, Ohtani Ryuji
Division of Cardiology, Tokushima Red Cross Hospital, Tokushima, Japan.
J Am Soc Echocardiogr. 2005 Jun;18(6):638-43. doi: 10.1016/j.echo.2004.09.024.
The aim of this study was to assess the role of cyclic variation (CV) of myocardial integrated backscatter (IBS) in the prediction of left ventricular (LV) remodeling in patients with anterior acute myocardial infarction (AMI) after primary coronary angioplasty.
Some studies have shown that the CV of myocardial IBS predicts myocardial viability for patients with AMI.
We recorded short-axis IBS images within 24 hours of angioplasty in 80 patients with anterior AMI. Two parameters were measured: the magnitude of CV and the normalized time delay (NTD). The increase in LV end-diastolic volume (LVEDV) at 4 weeks (DeltaLVEDV) was defined as LV remodeling (>20% increase from baseline).
Patients were divided into two groups according to LV remodeling status: the remodeling group (n = 41) and the nonremodeling group (n = 39). There was a significant difference in the magnitude of CV between the two groups (5.11 +/- 1.47 vs 5.96 +/- 189 dB, P < .05), and the NTD was significantly different in the two groups (1.57 +/- 0.31 vs 1.23 +/- 0.32, P < .0001). The correlation between the magnitude of CV and DeltaLVEDV was significant but weak (r = -0.338, P < .01). There was significant correlation between NTD and DeltaLVEDV (r = 0.443, P < .0001). Using NTD greater than 1.35 as the optimal cutoff, the sensitivity, specificity, and positive and negative predictive values to predict LV remodeling were 82%, 86%, 87%, and 80%, respectively.
Myocardial IBS, especially NTD, is useful for predicting LV remodeling in patients with AMI after primary coronary angioplasty.
本研究旨在评估心肌背向散射积分（IBS）的周期性变化（CV）在预测直接冠状动脉血管成形术后前壁急性心肌梗死（AMI）患者左心室（LV）重构中的作用。
一些研究表明，心肌IBS的CV可预测AMI患者的心肌存活性。
我们记录了80例前壁AMI患者血管成形术后24小时内的短轴IBS图像。测量了两个参数：CV的幅度和标准化时间延迟（NTD）。将4周时左心室舒张末期容积（LVEDV）的增加量（ΔLVEDV）定义为LV重构（较基线增加>20%）。
根据LV重构状态将患者分为两组：重构组（n = 41）和非重构组（n = 39）。两组间CV幅度有显著差异（5.11±1.47 vs 5.96±1.89 dB，P <.05），两组间NTD有显著差异（1.57±0.31 vs 1.23±0.32，P <.0001）。CV幅度与ΔLVEDV之间存在显著但较弱的相关性（r = -0.338，P <.01）。NTD与ΔLVEDV之间存在显著相关性（r = 0.443，P <.0001）。以NTD大于1.35作为最佳截断值，预测LV重构的敏感性、特异性、阳性预测值和阴性预测值分别为82%、86%、87%和80%。
心肌IBS，尤其是NTD，有助于预测直接冠状动脉血管成形术后AMI患者的LV重构。
