经食管实时三维超声心动图对心肌梗死后心力衰竭患者左心室功能的评估
Evaluation of left ventricular function in patients with heart failure after myocardial infarction by real-time three-dimensional transesophageal echocardiography.
作者信息
Miao Yanling, Kang Xiaoning
机构信息
Department II of Ultrasound, Cangzhou Central Hospital Cangzhou, China.
出版信息
Am J Transl Res. 2021 Sep 15;13(9):10380-10387. eCollection 2021.
OBJECTIVE
To evaluate the left ventricular function in patients with heart failure (HF) after myocardial infarction (MI) by real-time three-dimensional transesophageal echocardiography (RT-3D-TEE) and explore its correlation with serum cTnI and H-FABP levels.
METHODS
The data of 60 HF patients after MI from March 2019 to January 2021 were analyzed retrospectively and included in the research group. According to cardiac function grades, they were assigned to group A (20 cases), group B (20 cases), and group C (20 cases). During the same period, 50 healthy patients were included in the control group. The left atrial diameter (LAD), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular stroke volume (LVSV), and left ventricular ejection fraction (LVEF) of participants were recorded and compared in the four groups. The serum levels H-FABP and cTnI were tested by ELISA.
RESULTS
HF patients had poorer left heart structure and lower function and higher serum H-FABP and cTnI levels, as compared to the subjects in control group. Correlation analysis indicated that the cardiac function grade was positively correlated with LVEDV, LVESV, H-FABP, and cTnI, but negatively correlated with LVEF. The serum H-FABP and cTnI levels of HF patients were positively correlated with LVEDV and LVESV, but negatively correlated with LVEF. Logistic regression analysis revealed that cTnI and H-FABP were risk factors for HF, and LVEF was a protective factor for HF.
CONCLUSION
Serum H-FABP and cTnI levels in HF patients are correlated with left ventricular function parameters, which presents a close relation to HF. RT-3D-TEE combined with the detection of serum H-FABP and cTnI yields important clinical significance for early diagnosis of HF.
目的
采用实时三维经食管超声心动图（RT-3D-TEE）评估心肌梗死（MI）后心力衰竭（HF）患者的左心室功能，并探讨其与血清肌钙蛋白I（cTnI）和心脏型脂肪酸结合蛋白（H-FABP）水平的相关性。
方法
回顾性分析2019年3月至2021年1月期间60例MI后HF患者的数据，并将其纳入研究组。根据心功能分级，将他们分为A组（20例）、B组（20例）和C组（20例）。同期纳入50例健康患者作为对照组。记录并比较四组参与者的左心房内径（LAD）、室间隔厚度（IVST）、左心室后壁厚度（LVPWT）、左心室收缩末期容积（LVESV）、左心室舒张末期容积（LVEDV）、左心室每搏输出量（LVSV）和左心室射血分数（LVEF）。采用酶联免疫吸附测定法（ELISA）检测血清H-FABP和cTnI水平。
结果
与对照组相比，HF患者左心结构更差、功能更低，血清H-FABP和cTnI水平更高。相关性分析表明，心功能分级与LVEDV、LVESV、H-FABP和cTnI呈正相关，但与LVEF呈负相关。HF患者血清H-FABP和cTnI水平与LVEDV和LVESV呈正相关，但与LVEF呈负相关。Logistic回归分析显示，cTnI和H-FABP是HF的危险因素，而LVEF是HF的保护因素。
结论
HF患者血清H-FABP和cTnI水平与左心室功能参数相关，这与HF密切相关。RT-3D-TEE联合血清H-FABP和cTnI检测对HF的早期诊断具有重要临床意义。
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