Shao Chunlai, Zhu Jing, Chen Jianchang, Xu Weiting
Department of Cardiology, The Second Affiliated Hospital of Soochow University, Sanxiang Street 1055, Suzhou, China.
BMC Cardiovasc Disord. 2015 Nov 4;15:145. doi: 10.1186/s12872-015-0135-9.
The objective of this study is to evaluate left atrial(LA) function and its prognostic value by two-dimensional speckle tracking echocardiography (STE) in patients with non-ST-segment-elevation acute myocardial infarction (NSTEAMI).
Global longitudinal LA S/SR data obtained by 2D speckle imaging with automated software (Echo PAC, GE Medical).
Clinical variables and angiographic, echocardiographic, and STE parameters were studied in 65 patients with NSTEAMI (51 males and 14 females; mean age of 60.7 ± 9.8 years) who underwent elective PCI. The final study population consisted of 51 individuals (43 males and 8 females; mean age of 62.9 ± 11.1 years) and a 12 ± 3 months follow-up was performed. A total of 22 combined cardiovascular events(20 patients) occurred. With the use of Univariable Cox regression, all parameters were evaluated in the prediction of cardiac events, ischemic events, and/or cardiac death. According to ROC analysis, baseline mean global left atrial SRs (ROC area 0.82, p = 0.001) and baseline mean global left atrial SRe (ROC area 0.68, p = 0.036) were the only predictive variables.
In patients with NSTEAMI, we found that the novel global strain parameter of left atrial function is a valuable predictor of combined cardiovascular events over conventional echocardiography and may therefore be an important clinical tool for risk stratification in the acute phase of NSTEAMI.
本研究旨在通过二维斑点追踪超声心动图（STE）评估非ST段抬高型急性心肌梗死（NSTEAMI）患者的左心房（LA）功能及其预后价值。
通过自动软件（Echo PAC，GE医疗）的二维斑点成像获得左心房整体纵向S/SR数据。
对65例接受择期经皮冠状动脉介入治疗（PCI）的NSTEAMI患者（51例男性和14例女性；平均年龄60.7±9.8岁）的临床变量、血管造影、超声心动图和STE参数进行了研究。最终研究人群包括51人（43例男性和8例女性；平均年龄62.9±11.1岁），并进行了12±3个月的随访。共发生22例心血管事件合并症（20例患者）。使用单变量Cox回归分析，评估所有参数对心脏事件、缺血事件和/或心源性死亡的预测价值。根据ROC分析，基线左心房整体平均SRs（ROC曲线下面积0.82，p = 0.001）和基线左心房整体平均SRe（ROC曲线下面积0.68，p = 0.036）是唯一的预测变量。
在NSTEAMI患者中，我们发现左心房功能的新型整体应变参数是比传统超声心动图更有价值的心血管事件合并症预测指标，因此可能是NSTEAMI急性期风险分层的重要临床工具。
