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二维应变成像在预测梗死相关动脉经皮血管重建术后心肌功能恢复中的价值。

Value of two-dimensional strain imaging in prediction of myocardial function recovery after percutaneous revascularization of infarct-related artery.

作者信息

Shehata Mohamed

机构信息

Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

出版信息

Echocardiography. 2015 Apr;32(4):630-7. doi: 10.1111/echo.12704. Epub 2014 Nov 24.

Abstract

BACKGROUND

Speckle tracking is integrated into echocardiographic systems for evaluation of left ventricular (LV) function by means of automated function imaging (AFI). This study aimed at evaluating role of AFI-based strain in predicting postpercutaneous coronary intervention (PCI) LV function recovery.

METHODS

Fifty patients with anterior wall myocardial infarction and impaired LV ejection fraction (LVEF) were prospectively enrolled. All patients showed positive viability results concerning left anterior descending (LAD) artery territory using low-dose dobutamine stress echocardiography (LDSE). All patients underwent strain imaging using AFI (before and after PCI).

RESULT

Mean age of the study population was 56.2 ± 5.4 years, 34 (68%) being males. 24 (48%) patients showed post-PCI LV function recovery after 4 months. They showed higher pre-PCI LVEF and AFI-based strain values. Logistic regression analysis presented baseline LVEF as an independent predictor of LV function recovery (Odds ratio = 0.7026, 95% CI: 0.54-0.93). A pre-PCI AFI strain value of -4.5% (sensitivity: 84% and specificity: 75%) for LAD territory and -9.5% (sensitivity and specificity of 50%) for global LV predicted LV function recovery.

CONCLUSION

Assessment of global and territorial LV strains using AFI; is of added value upon viability assessment using LDSE. Higher baseline LVEF and strain values are associated with post-PCI LV function recovery.

摘要

背景

斑点追踪技术已整合到超声心动图系统中,通过自动功能成像(AFI)来评估左心室(LV)功能。本研究旨在评估基于AFI的应变在预测经皮冠状动脉介入治疗(PCI)后左心室功能恢复中的作用。

方法

前瞻性纳入50例前壁心肌梗死且左心室射血分数(LVEF)受损的患者。所有患者使用低剂量多巴酚丁胺负荷超声心动图(LDSE)显示左前降支(LAD)动脉区域存活结果为阳性。所有患者均接受AFI应变成像(PCI前后)。

结果

研究人群的平均年龄为56.2±5.4岁,男性34例(68%)。24例(48%)患者在4个月后显示PCI后左心室功能恢复。他们在PCI前显示出更高的LVEF和基于AFI的应变值。逻辑回归分析显示基线LVEF是左心室功能恢复的独立预测因子(比值比=0.7026,95%可信区间:0.54-0.93)。LAD区域PCI前AFI应变值为-4.5%(敏感性:84%,特异性:75%),左心室整体为-9.5%(敏感性和特异性均为50%)可预测左心室功能恢复。

结论

使用AFI评估左心室整体和局部应变;在使用LDSE进行存活评估时具有附加价值。更高的基线LVEF和应变值与PCI后左心室功能恢复相关。

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