University Center for Cardiology, Dębinki 2, 80-211 Gdańsk, Poland.
Pomeranian Cardiology Centers.
Cardiol J. 2021;28(1):77-85. doi: 10.5603/CJ.a2019.0098. Epub 2019 Oct 23.
The purpose of this study was to analyze hemodynamic changes in patients treated with percutaneous coronary intervention (PCI) at an early stage of acute myocardial infarction (AMI) and at 1-month follow-up.
Patients with AMI (n = 27) who underwent PCI were analyzed using impedance cardiography (ICG). ICG data were collected continuously (beat by beat) during the whole PCI procedure and thereafter at every 60 s for the next 24 h. Blood pressure was taken every 10 min and stored for analysis. Additionally the following parameters were measured: cardiac index (CI), stroke volume index (SVi), left cardiac work index (LCWi), contractility index (CTi), ventricular ejection time (VET), systemic vascular resistance index (SVRi), thoracic fluid content index (TFCi) and heart rate (HR).
In the first 24 h after PCI all the contractility parameters including CI, SVi, LCWi, CTi and VET significantly decreased, whereas HR, SVRi and TFCi increased compared to baseline. All of the parameters examined got normalized at 1 month. The CI, SVi, LCWi, CTi, SVRi did not significantly differ from baseline, however the HR and VET were significantly lower compared to first day after PCI CONCLUSIONS: Cardiac performance deteriorates early after PCI and normalizes after 1 month in patients with an AMI. ICG is useful for hemodynamic monitoring of AMI patients during and after invasive therapy.
本研究旨在分析急性心肌梗死(AMI)早期及 1 个月随访行经皮冠状动脉介入治疗(PCI)患者的血流动力学变化。
采用阻抗心动描记法(ICG)分析 27 例 AMI 患者行 PCI 的情况。在整个 PCI 过程中连续(逐拍)采集 ICG 数据,此后在接下来的 24 小时内每 60 秒采集一次。每 10 分钟测量一次血压并储存用于分析。此外,还测量了以下参数:心指数(CI)、每搏输出量指数(SVi)、左心做功指数(LCWi)、收缩性指数(CTi)、心室射血时间(VET)、全身血管阻力指数(SVRi)、胸液含量指数(TFCi)和心率(HR)。
在 PCI 后 24 小时内,与基线相比,所有收缩性参数(包括 CI、SVi、LCWi、CTi 和 VET)均显著降低,而 HR、SVRi 和 TFCi 则升高。所有参数在 1 个月时均恢复正常。CI、SVi、LCWi、CTi、SVRi 与基线无显著差异,但与 PCI 后第 1 天相比,HR 和 VET 显著降低。
AMI 患者 PCI 后早期心功能恶化,1 个月后恢复正常。ICG 可用于 AMI 患者介入治疗期间和之后的血流动力学监测。