Tomoaia Raluca, Beyer Ruxandra Stefana, Simu Gelu, Serban Adela Mihaela, Pop Dana
Cardiology Department "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Heart Institute "N. Stancioiu", Cluj-Napoca, Romania.
Med Ultrason. 2019 Feb 17;21(1):69-76. doi: 10.11152/mu-1768.
Despite the use of reperfusion therapies in the last decades, acute myocardial infarction further remains one of the most frequent causes of mortality. This is mainly caused by changes in the ventricular architecture leading to ventricular remodeling, followed by progressive development of heart failure. Transthoracic echocardiography is a non-invasive instrument which can provide information about the extent of the ischemic process and its consequences but can also predict the outcomes after myocardial infarction. Although standard echocardiographic parameters are currently used for risk stratification of these patients, they might not truly reflect left ventricular systolic dysfunction in acute myocardial infarct patients, since the detection of subtle changes in the myocardial function is beyond their limits. The aim of this review is to underline the use of advanced echocardiographic parameters in identifying patients at risk for developing post-acute myocardial infarction heart failure and subsequent adverse events. Advanced echocardiographic parameters derived from speckle tracking echocardiography provide a detailed assessment on the global and regional left ventricular deformation. Therefore, speckle tracking echocardiography has a major role in predicting the prognosis of acute myocardial infarction patients and particularly in the development ofsubsequent heart failure, which might be prevented with early initiation of adequate therapy.
尽管在过去几十年中使用了再灌注疗法，但急性心肌梗死仍然是最常见的死亡原因之一。这主要是由心室结构改变导致心室重构引起的，随后会逐渐发展为心力衰竭。经胸超声心动图是一种非侵入性检查手段，它不仅可以提供有关缺血过程的范围及其后果的信息，还可以预测心肌梗死后的预后。虽然目前标准的超声心动图参数用于这些患者的风险分层，但它们可能无法真正反映急性心肌梗死患者的左心室收缩功能障碍，因为检测心肌功能的细微变化超出了它们的能力范围。本综述的目的是强调使用先进的超声心动图参数来识别急性心肌梗死后发生心力衰竭及后续不良事件风险的患者。源自斑点追踪超声心动图的先进超声心动图参数可对左心室整体和局部变形进行详细评估。因此，斑点追踪超声心动图在预测急性心肌梗死患者的预后，特别是在随后心力衰竭的发生方面具有重要作用，而早期启动适当治疗可能会预防心力衰竭的发生。
