Kaya Ergün Bariş, Ozer Necla, Aksoy Hakan, Deveci Onur Sinan, Tülümen Erol, Okutucu Sercan, Yorgun Hikmet, Atalar Enver, Aksöyek Serdar, Ozmen Ferhan, Ovünç Kenan, Kes Sirri, Ozkutlu Hilmi
Hacettepe Universitesi Tip Fakültesi, Kardiyoloji Anabilim Dali, Ankara, Türkiye.
Anadolu Kardiyol Derg. 2010 Jun;10(3):239-46. doi: 10.5152/akd.2010.064.
To evaluate the diagnostic value of mean annular velocity (MAV) and strain score index (SSI) for determination of the left ventricular systolic dysfunction in patients with first acute myocardial infarction (AMI).
Seventy-one patients (55 male, mean age: 59+/-12 years) with first acute ST-elevation myocardial infarction and 30 healthy subjects were included in this cross-sectional and observational study. Echocardiography with tissue Doppler and strain analysis was performed during initial hospital admission. Peak systolic myocardial velocities were recorded from 4 different sites on the mitral annulus. A MAV value was calculated and the peak systolic strain values of 12 segments were measured and a mean SSI was calculated. ROC curve analysis was used in order to determine cut-off values for MAV and SSI.
The patients with AMI had a significantly reduced MAV compared with healthy subjects (5.52+/-1.78 cm/s vs 9.80+/-1.13 cm/s, p<0.001). In ROC analysis, a cut-off value of 8.41 cm/s (AUC 0.915, 95%CI 0.887-0.952, p<0.001) for MAV differentiated AMI patients from controls with 97.2% sensitivity and 93.3% specificity. The patients with AMI have also decreased SSI (11.23+/-2.83 vs 19.11+/-2.05, p<0.001). A cut-off value of 15.35% differentiated AMI patients from controls with 94.4% sensitivity and 100% specificity (ROC AUC 0.945, 95%CI 0.901-0.972, p<0.001). There was a good correlation between left ventricular EF and MAV (r=0.73, p<0.001) and SSI (r=0.66, p<0.001).
The patients with first myocardial infarction have decreased mean systolic annular velocity and mean systolic strain score index.
评估平均环周速度（MAV）和应变评分指数（SSI）对首次急性心肌梗死（AMI）患者左心室收缩功能障碍的诊断价值。
本横断面观察性研究纳入了71例首次急性ST段抬高型心肌梗死患者（55例男性，平均年龄：59±12岁）和30例健康受试者。在初次入院期间进行了组织多普勒和应变分析的超声心动图检查。从二尖瓣环的4个不同部位记录收缩期心肌峰值速度。计算MAV值，测量12个节段的收缩期峰值应变值，并计算平均SSI。采用受试者工作特征（ROC）曲线分析来确定MAV和SSI的临界值。
与健康受试者相比，AMI患者的MAV显著降低（5.52±1.78 cm/s对9.80±1.13 cm/s，p<0.001）。在ROC分析中，MAV的临界值为8.41 cm/s（曲线下面积[AUC] 0.915，95%可信区间[CI] 0.887 - 0.952，p<0.001），区分AMI患者与对照组的敏感性为97.2%，特异性为93.3%。AMI患者的SSI也降低（11.23±2.83对19.11±2.05，p<0.001）。临界值为15.35%时，区分AMI患者与对照组的敏感性为94.4%，特异性为100%（ROC AUC 0.945，95%CI 0.901 - 0.972，p<0.001）。左心室射血分数（EF）与MAV（r = 0.73，p<0.001）和SSI（r = 0.66，p<0.001）之间存在良好的相关性。
首次心肌梗死患者的平均收缩期环周速度和平均收缩期应变评分指数降低。
