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压力-应变环技术评价非 ST 段抬高型急性冠状动脉综合征患者经皮冠状动脉介入治疗前后左心室心肌做功。

Assessment of Myocardial Work of the Left Ventricle before and after PCI in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome by Pressure-Strain Loop Technology.

机构信息

Department of Science and Education, The First Affiliated Hospital of Kangda College of Nanjing Medical University/The First People's Hospital of Lianyungang, Lianyungang 222002, China.

Department of Heart Function Test, The First Affiliated Hospital of Kangda College of Nanjing Medical University/The First People's Hospital of Lianyungang, Lianyungang 222002, China.

出版信息

Comput Math Methods Med. 2022 May 26;2022:8026689. doi: 10.1155/2022/8026689. eCollection 2022.

Abstract

OBJECTIVES

Noninvasive left ventricular pressure-strain loop (PSL) is a new method for quantitative evaluation of myocardial work, which is developed on the basis of speckle tracking echocardiography. It is necessary to fit the noninvasive left ventricular pressure and the strain by speckle tracking echocardiography to construct a pressure-strain loop. Compared with traditional left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), it has potential application value and is a useful supplement for clinical evaluation of left ventricular systolic function. We perform this study to evaluate the changes of myocardial function in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) before and after percutaneous coronary intervention (PCI) with noninvasive left ventricular pressure-strain loop (PSL).

METHODS

33 NSTE-ACS patients admitted to the Department of Cardiovascular Medicine of the Affiliated Lianyungang Hospital of Xuzhou Medical University who successfully underwent early PCI were included as the PCI group. At the same time, 30 healthy patients matched in age and sex were selected as the control group. All patients received routine echocardiography. The parameters such as GWI, GCW, GWW, and GWE were obtained by EchoPAC 203 software. The differences in the general clinical data and echocardiographic parameters between the two groups, including controls and patients 1 day before surgery and 1 month after surgery, were compared.

RESULTS

Compared with the control group, GWI, GCW, and GWI in the PCI group were decreased 1 day before surgery and 1 month after surgery, while GWW was increased, with statistical significance ( < 0.05). In the PCI group, compared with 1 day before surgery, GWI and GCW were all increased 1 month after surgery ( < 0.05), and GWW and GWE were not significantly different between the two groups ( > 0.05).

CONCLUSION

The noninvasive left ventricular PSL technology can early and accurately evaluate the myocardial function impairment in NSTE-ACS patients and the recovery of myocardial function after PCI, providing a new noninvasive method for clinical postoperative myocardial function evaluation.

摘要

目的

无创左心室压力-应变环(PSL)是一种基于斑点追踪超声心动图的新的心肌做功定量评估方法。它需要通过斑点追踪超声心动图拟合无创左心室压力和应变来构建压力-应变环。与传统的左心室射血分数(LVEF)和整体纵向应变(GLS)相比,它具有潜在的应用价值,是临床左心室收缩功能评估的有益补充。我们进行这项研究是为了评估经皮冠状动脉介入治疗(PCI)前后非 ST 段抬高型急性冠状动脉综合征(NSTE-ACS)患者的心肌功能变化。

方法

纳入 33 例在徐州医科大学附属医院心血管内科成功行早期 PCI 的 NSTE-ACS 患者作为 PCI 组,同时选取同期年龄、性别相匹配的 30 例健康者作为对照组。所有患者均行常规超声心动图检查,应用 EchoPAC 203 软件获取 GWI、GCW、GWW 和 GWE 等参数。比较两组患者(包括对照组和术前 1 天、术后 1 个月的患者)一般临床资料及超声心动图参数的差异。

结果

与对照组相比,PCI 组患者术前 1 天及术后 1 个月的 GWI、GCW 降低,GWW 升高,差异有统计学意义( < 0.05)。与术前 1 天比较,PCI 组患者术后 1 个月的 GWI 和 GCW 均升高,差异有统计学意义( < 0.05),GWW 和 GWE 差异无统计学意义( > 0.05)。

结论

无创左心室 PSL 技术能够早期、准确地评估 NSTE-ACS 患者的心肌功能损害及 PCI 后心肌功能的恢复,为临床术后心肌功能评估提供了一种新的无创方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b73/9162807/a3296c7cbaaa/CMMM2022-8026689.001.jpg

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