Bøhmer Ellen, Hoffmann Pavel, Abdelnoor Michael, Seljeflot Ingebjørg, Halvorsen Sigrun
Department of Medicine, Innlandet Hospital Trust, Lillehammer, Norway.
Cardiology. 2009;113(3):207-12. doi: 10.1159/000201991. Epub 2009 Feb 14.
The evaluation of infarct size and left ventricular function after acute myocardial infarction is important for predicting the subsequent clinical course. This assessment can be achieved by non-invasive imaging methods, but biochemical assays are frequently used as an alternative. We investigated the ability of a single measurement of cardiac troponin T (cTnT) the third morning after onset of ST-segment elevation myocardial infarction (STEMI) to predict infarct size and left ventricular ejection fraction (LVEF).
The study population consisted of 103 patients with their first STEMI treated with thrombolysis. Blood samples for determination of cTnT were drawn the third morning after onset of symptoms. Infarct size and LVEF were assessed by magnetic resonance imaging 3 months later.
Linear regression analysis showed a strong, significant correlation between third-day cTnT and infarct size at 3 months (r = 0.84, p < 0.0001). A significant but inverse and weaker correlation was obtained between third-day cTnT and LVEF (r = -0.63, p < 0.0001). Adjusting for age, gender, infarct location and medication changed the results marginally.
A single cTnT value the third morning after onset of STEMI predicted the final infarct size in this group of patients with their first STEMI, and might be useful for ruling out impaired LVEF.
评估急性心肌梗死后的梗死面积和左心室功能对于预测后续临床病程至关重要。这种评估可以通过非侵入性成像方法实现，但生化检测也经常作为一种替代方法使用。我们研究了在ST段抬高型心肌梗死（STEMI）发病后第三天早晨单次测量心肌肌钙蛋白T（cTnT）预测梗死面积和左心室射血分数（LVEF）的能力。
研究人群包括103例接受溶栓治疗的首次STEMI患者。在症状发作后第三天早晨采集用于测定cTnT的血样。3个月后通过磁共振成像评估梗死面积和LVEF。
线性回归分析显示第三天的cTnT与3个月时的梗死面积之间存在强烈、显著的相关性（r = 0.84，p < 0.0001）。第三天的cTnT与LVEF之间存在显著但呈负相关且较弱的相关性（r = -0.63，p < 0.0001）。对年龄、性别、梗死部位和用药进行校正后，结果仅有轻微变化。
在这组首次发生STEMI的患者中，STEMI发病后第三天早晨的单次cTnT值可预测最终梗死面积，可能有助于排除LVEF受损情况。
