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经皮冠状动脉介入治疗后残余冠状动脉疾病对左心室功能的影响:二维应变成像研究。

Impact of residual coronary artery disease on left ventricular function after percutaneous coronary intervention: a two-dimensional strain echocardiography study.

机构信息

University of Health Sciences Bursa Yuksek Ihtisas Training and Research Hospital, Mimar Sinan mahallesi, Polis Okulu Karşısı, Emniyet Caddesi, 16310, Yıldırım, Bursa, Turkey.

出版信息

Herz. 2023 Mar;48(2):152-158. doi: 10.1007/s00059-022-05151-5. Epub 2022 Dec 30.

Abstract

BACKGROUND

The aim of this study was to investigate the relationship between the residual SYNTAX score (rSS) and recovery of left ventricular function after percutaneous coronary intervention (PCI) in stable symptomatic patients.

METHOD

Overall, 81 patients (mean age: 62.3 ± 9.1 years, 72.8% male) were included in the study. Echocardiographic parameters were measured before PCI (baseline) and 3 months after PCI (follow-up). The patients were divided into two groups based on rSS: complete revascularized group (CR) with rSS = 0 (n =32; 39.5%) and incomplete revascularized group (iCR) with rSS > 0 (n = 49; 60.5%).

RESULTS

The median (25th-75th percentile) SYNTAX score (SS) and rSS values were 8 (5-11) and 2 (0-3), respectively. The difference between basal and follow-up global longitudinal strain (GLS) values (∆ GLS) was significantly higher in the CR group (1.25% ± 1.52 vs. 0.11% ± 1.66% p = 0.003). At the follow-up, there was a significant increase in left ventricular ejection fraction (58.41 ± 6.91% vs. 61.74 ± 5.76%, p < 0.001), a significant decrease in Tei index (0.46 ± 0.18 vs. 0.35 ± 0.16%, p < 0.001), and a significant increase in GLS (14.92 ± 2.76% vs. -15.49 ± 2.66%, p = 0.004). In the linear regression analysis, the only variable related to ∆ GLS was rSS (β = -0.113, 95% CI: -0.217--0.010; p = 0.033).

CONCLUSION

Increased residual coronary artery disease burden has a negative impact on recovery of left ventricular function after PCI.

摘要

背景

本研究旨在探讨稳定型有症状患者经皮冠状动脉介入治疗(PCI)后残余 SYNTAX 评分(rSS)与左心室功能恢复之间的关系。

方法

共纳入 81 例患者(平均年龄 62.3±9.1 岁,72.8%为男性)。在 PCI 前(基线)和 PCI 后 3 个月(随访)测量超声心动图参数。根据 rSS 将患者分为两组:rSS=0 的完全血运重建组(CR)(n=32;39.5%)和 rSS>0 的不完全血运重建组(iCR)(n=49;60.5%)。

结果

中位(25 至 75 百分位数)SYNTAX 评分(SS)和 rSS 值分别为 8(5-11)和 2(0-3)。CR 组的基础和随访时的整体纵向应变(GLS)差值(ΔGLS)明显更高(1.25%±1.52% vs. 0.11%±1.66%,p=0.003)。在随访时,左心室射血分数(58.41%±6.91% vs. 61.74%±5.76%,p<0.001)显著增加,Tei 指数(0.46±0.18 vs. 0.35±0.16%,p<0.001)显著降低,GLS 显著增加(14.92%±2.76% vs. -15.49%±2.66%,p=0.004)。在线性回归分析中,与ΔGLS 相关的唯一变量是 rSS(β=-0.113,95%CI:-0.217--0.010;p=0.033)。

结论

残余冠状动脉病变负担的增加对 PCI 后左心室功能的恢复有负面影响。

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