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ST段抬高型心肌梗死再灌注治疗后四维斑点追踪成像风险分类与TIMI系统预测价值的比较

Comparison of the predictive value of four-dimensional speckle tracking imaging risk classification and the TIMI system after STEMI reperfusion therapy.

作者信息

Wang Yingchun, Xu Rong, Yin Xiaohua, Wang Jing, Feng Lan, Zhou Jie

机构信息

Department of Ultrasound, Shanghai Jiading Center Hospital, Shanghai 201800, P.R. China.

Department of Radiology, Shanghai Jiading Center Hospital, Shanghai 201800, P.R. China.

出版信息

Exp Ther Med. 2018 Nov;16(5):4129-4135. doi: 10.3892/etm.2018.6666. Epub 2018 Aug 29.

Abstract

The predictive value of four-dimensional speckle tracking imaging (4D-STI) risk classification and TIMI risk scores for the prognosis of patients with ST-segment elevation myocardial infarction (STEMI) after reperfusion therapy were investigated. One hundred and twenty patients with STEMI after reperfusion therapy were involved. At 12 h after reperfusion therapy, 2nd and 3rd day, the three-dimensional longitudinal strain (LS), circumferential strain (CS) and radial strain (RS), area strain (AS), as well as other 4D-STI detection indicators, were collected. The patients were followed up for one year, and were divided into good prognosis group and poor prognosis group. LS, CS, RS and AS indicators were analyzed between these two groups. The ROC curve was drawn to establish the 4D-STI risk classification and its predictive value for poor prognosis and mortality were compared with TIMI risk scores. AS, LS and RS at 12 h after reperfusion treatment, and AS and RS at 2nd and 3rd day had a certain degree of prediction accuracy in STEMI patients in the poor prognosis group. In the 4D-STI and TIMI risk scores, the risk of death and adverse prognosis significantly increased as the risk scores increased (P<0.01). The 4D-STI risk score for predicting poor prognosis and mortality was greater than the TIMI risk score. 4D-STI risk scores are superior to TIMI risk scores in predicting poor prognosis and mortality in patients with STEMI after reperfusion therapy.

摘要

研究了四维斑点追踪成像(4D-STI)风险分类和TIMI风险评分对ST段抬高型心肌梗死(STEMI)患者再灌注治疗后预后的预测价值。纳入120例STEMI再灌注治疗患者。在再灌注治疗后12小时、第2天和第3天,采集三维纵向应变(LS)、圆周应变(CS)、径向应变(RS)、面积应变(AS)以及其他4D-STI检测指标。对患者进行一年随访,并分为预后良好组和预后不良组。分析两组之间的LS、CS、RS和AS指标。绘制ROC曲线以建立4D-STI风险分类,并将其对不良预后和死亡率的预测价值与TIMI风险评分进行比较。再灌注治疗后12小时的AS、LS和RS,以及第2天和第3天的AS和RS对预后不良组的STEMI患者有一定程度的预测准确性。在4D-STI和TIMI风险评分中,随着风险评分增加,死亡和不良预后风险显著增加(P<0.01)。预测不良预后和死亡率的4D-STI风险评分大于TIMI风险评分。在预测STEMI患者再灌注治疗后的不良预后和死亡率方面,4D-STI风险评分优于TIMI风险评分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbd7/6200968/bac8b0332113/etm-16-05-4129-g00.jpg

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