Department of Internal Medicine, Botucatu Medical School, UNESP, Botucatu, Brazil.
Med Sci Monit. 2012 Jul;18(7):BR253-8. doi: 10.12659/msm.883202.
The objective of this study was to determine the early echocardiographic predictors of elevated left ventricular end-diastolic pressure (LVEDP) after a long follow-up period in the infarcted rat model.
MATERIAL/METHODS: Five days and three months after surgery, sham and infarcted animals were subjected to transthoracic echocardiography. Regression analysis and receiver-operating characteristic (ROC) curve were performed for predicting increased LVEDP 3 months after MI.
Among all of the variables, assessed 5 days after myocardial infarction, infarct size (OR: 0.760; CI 95% 0.563-0.900; p=0.005), end-systolic area (ESA) (OR: 0.761; CI 95% 0.564-0.900; p=0.008), fractional area change (FAC) (OR: 0.771; CI 95% 0.574-0.907; p=0.003), and posterior wall-shortening velocity (PWSV) (OR: 0.703; CI 95% 0.502-0.860; p=0.048) were predictors of increased LVEDP. The LVEDP was 3.6±1.8 mmHg in the control group and 9.4±7.8 mmHg among the infarcted animals (p=0.007). Considering the critical value of predictor variables in inducing cardiac dysfunction, the cut-off value was 35% for infarct size, 0.33 cm2 for ESA, 40% for FAC, and 26 mm/s for PWSV.
Infarct size, FAC, ESA, and PWSV, assessed five days after myocardial infarction, can be used to estimate an increased LVEDP three months following the coronary occlusion.
本研究旨在确定在梗死大鼠模型的长期随访后，左心室舒张末期压（LVEDP）升高的早期超声心动图预测因子。
材料/方法：手术后 5 天和 3 个月，假手术和梗死动物接受经胸超声心动图检查。进行回归分析和接收者操作特征（ROC）曲线分析，以预测 MI 后 3 个月 LVEDP 升高。
在心肌梗死后 5 天评估的所有变量中，梗死面积（OR：0.760；95%CI 0.563-0.900；p=0.005）、收缩末期面积（ESA）（OR：0.761；95%CI 0.564-0.900；p=0.008）、射血分数（FAC）（OR：0.771；95%CI 0.574-0.907；p=0.003）和后侧壁缩短速度（PWSV）（OR：0.703；95%CI 0.502-0.860；p=0.048）是 LVEDP 升高的预测因子。对照组的 LVEDP 为 3.6±1.8mmHg，梗死组为 9.4±7.8mmHg（p=0.007）。考虑到预测变量在诱导心功能障碍方面的临界值，梗死面积的临界值为 35%，ESA 为 0.33cm2，FAC 为 40%，PWSV 为 26mm/s。
心肌梗死后 5 天评估的梗死面积、FAC、ESA 和 PWSV 可用于估计冠状动脉闭塞后 3 个月 LVEDP 的升高。
