Dogan Cem, Omaygenc Onur, Hatipoglu Suzan, Bakal Ruken B, Demirkiran Aykut, Emiroglu M Yunus, Bayram Tulay, Ozdemir Nihal
Kosuyolu Heart & Research Hospital, Istanbul, Turkey.
Echocardiography. 2013 Mar;30(3):279-84. doi: 10.1111/echo.12048. Epub 2012 Nov 27.
It is well known that patients with ST-elevation myocardial infarction (STEMI) show both systolic and diastolic left ventricular dysfunction. The aim of this study was to assess post-myocardial infarction diastolic dysfunction using left atrial ejection force (LAEF) in patients treated with primary percutaneous coronary intervention (PCI).
We enrolled 58 patients presenting with STEMI who were treated with primary PCI and 23 healthy subjects as a control group. A detailed transthoracic echocardiogram, including mitral flow velocities, tissue Doppler mitral annular velocities, and left atrial (LA) phasic volumes, was performed in both groups. We also measured the level of B-type natriuretic peptide (BNP). LAEF was calculated using the formula: 0.5 × P × Mitral orifice area × (Peak A velocity)(2) . Correlations between variables were studied using "Pearson and Spearman's rho" test. In the test group, we found that the level of BNP in the plasma, E/E' ratio, and the LA volume measurements were higher than that of the control group, and those differences were statistically significant. LAEF was increased in patients with myocardial infarction (MI); moderately correlated to BNP (r = 0.383 and P = 0.001) and E/E' (r = 0.473 and P = 0.001), and strongly correlated to A-wave velocity (r = 0.731 and P = 0.001). LAEF was also negatively correlated to E/A ratio (r = -0.419 and P = 0.001) and LVEF (r = -0.339 and P = 0.003).
Impaired diastolic function in STEMI affects LA and increased LAEF is one of its manifestations. LAEF may also have diagnostic importance in diastolic dysfunction, but these findings should be confirmed by further studies.
众所周知，ST段抬高型心肌梗死（STEMI）患者存在左心室收缩和舒张功能障碍。本研究旨在评估接受直接经皮冠状动脉介入治疗（PCI）的患者中，利用左心房射血力（LAEF）评估心肌梗死后舒张功能障碍。
我们纳入了58例接受直接PCI治疗的STEMI患者，并选取23名健康受试者作为对照组。两组均进行了详细的经胸超声心动图检查，包括二尖瓣血流速度、组织多普勒二尖瓣环速度和左心房（LA）相位容积。我们还测量了B型利钠肽（BNP）水平。LAEF采用以下公式计算：0.5×P×二尖瓣口面积×（A峰峰值速度）² 。使用“Pearson和Spearman相关系数”检验研究变量之间的相关性。在试验组中，我们发现血浆中BNP水平、E/E'比值和LA容积测量值均高于对照组，且这些差异具有统计学意义。心肌梗死（MI）患者的LAEF升高；与BNP中度相关（r = 0.383，P = 0.001）和E/E'（r = 0.473，P = 0.001），与A波速度高度相关（r = 0.731，P = 0.001）。LAEF还与E/A比值呈负相关（r = -0.419，P = 0.001）和左心室射血分数（LVEF）呈负相关（r = -0.339，P = 0.003）。
STEMI患者舒张功能受损影响左心房，LAEF升高是其表现之一
