左心房容积指数与左心室射血分数比值预测ST段抬高型心肌梗死患者8年随访期间的主要不良心血管事件
Left Atrial Volume Index to Left Ventricular Ejection Fraction Ratio Predicted Major Adverse Cardiovascular Event in ST-Elevated Myocardial Infarction Patients during 8 Years of Follow-up.
作者信息
Yilmaz Ahmet Seyda, Kahraman Fatih, Ergül Elif, Çetin Mustafa
机构信息
Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
Department of Cardiology, Kütahya Evliya Çelebi Training and Research Hospital, Kütahya, Turkey.
出版信息
J Cardiovasc Echogr. 2021 Oct-Dec;31(4):227-233. doi: 10.4103/jcecho.jcecho_38_21. Epub 2022 Jan 24.
OBJECTIVE
It is crucial to determine the high-risk group in ST-elevated myocardial infarction (STEMI). Left ventricle ejection fraction (LVEF) and left atrial volume index (LAVI) are the well-established parameters for risk prediction. However, major adverse cardiovascular events (MACEs) may be predicted less than actual when LVEF or LAVI are in the normal range. It was investigated LAVI to LVEF ratio (LAVI/LVEFr) for more accurate MACE prediction.
METHODS
Patients with STEMI were included in the study. LAVI and LVEF were obtained at admission. The LAVI/LVEFr was calculated as LAVI dividing by LVEF. The composite primary endpoint of the study was all-cause mortality and new-onset heart failure for 8 years follow-up.
RESULTS
A total of 176 patients were divided into two groups according to the presence of MACE. MACE (+) group consisted of 70 (39.7%) patients who were older and more likely to be male. While LVEF ( < 0.001) was lower, LAVI ( < 0.001) and LAVI/LVEFr ( < 0.001) were higher in MACE (+) group. Age ( = 0.003), serum creatinine ( < 0.001), and LAVI/LVEFr ( < 0.001) were independent predictors of MACE.
CONCLUSION
Combined usage of LAVI and LVEF (LAVI/LVEFr), increased age, and serum creatinine level were the independent predictors of MACE during 8 years of follow-up in STEMI patients.
目的
确定ST段抬高型心肌梗死（STEMI）的高危人群至关重要。左心室射血分数（LVEF）和左心房容积指数（LAVI）是公认的风险预测参数。然而，当LVEF或LAVI在正常范围内时，主要不良心血管事件（MACE）的预测可能低于实际情况。本研究旨在探讨LAVI与LVEF比值（LAVI/LVEFr）对MACE进行更准确的预测。
方法
纳入STEMI患者进行研究。入院时获取LAVI和LVEF。LAVI/LVEFr通过LAVI除以LVEF计算得出。本研究的复合主要终点为8年随访期间的全因死亡率和新发心力衰竭。
结果
根据是否发生MACE，共176例患者分为两组。MACE（+）组由70例（39.7%）患者组成，这些患者年龄较大且更可能为男性。MACE（+）组的LVEF较低（<0.001），而LAVI（<0.001）和LAVI/LVEFr较高（<0.001）。年龄（=0.003）、血清肌酐（<0.001）和LAVI/LVEFr（<0.001）是MACE的独立预测因素。
结论
LAVI与LVEF联合使用（LAVI/LVEFr）、年龄增加和血清肌酐水平是STEMI患者8年随访期间MACE的独立预测因素。
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