心脏磁共振特征追踪技术测量的左心房和左心室纵向应变可改善 ST 段抬高型心肌梗死患者的预后分层。
Left atrial and ventricular longitudinal strain by cardiac magnetic resonance feature tracking improves prognostic stratification of patients with ST-segment elevation myocardial infarction.
机构信息
Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99#, Huaihai West Road, Xuzhou, 221002, China.
Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, 99#, Huaihai West Road, Xuzhou, China.
出版信息
Int J Cardiovasc Imaging. 2024 Sep;40(9):1881-1890. doi: 10.1007/s10554-024-03174-z. Epub 2024 Jul 10.
We aimed to investigate the predictive value of left atrium (LA) and left ventricle (LV) longitudinal strain derived by CMR-FT early after ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Patients with STEMI who received pPCI and completed CMR within the following week were enrolled. LA and LV longitudinal strain parameters were derived from cine CMR by FT; conventional CMR indexes were also performed. The primary endpoint was the occurrence of major cardiovascular adverse events (MACE), defined as a composite of death, reinfarction, and congestive heart failure (HF). 276 participants (median age, 57 years, IQR, 48-66 years; 85% men) were included in this study. CMR was usually completed on the 5 (IQR,4-7) days after pPCI. During a median follow-up of 16 months, MACE occurred in 35 (12.7%) participants. Multivariable Cox regression analysis showed that LA conduit strain (HR 0.91, 95%CI: 0.84, 0.98, p = 0.013) and LV global longitudinal strain (HR 1.17, 95%CI: 1.03, 1.34, p = 0.016) remained independently associated with MACE. Participants with impaired LA conduit strain (≤ 12.8%) and LV global longitudinal strain (> -13.1%) had a higher risk of MACE than those with preserved. Longitudinal strain of LA and LV could provide independent prognostic information in STEMI patients, and comprehensive assessment of Left atrial and ventricular longitudinal strain significantly improved the prognosis.
我们旨在研究经皮冠状动脉介入治疗(pPCI)治疗的 ST 段抬高型心肌梗死(STEMI)患者左心房(LA)和左心室(LV)纵向应变的预测价值。本研究纳入了接受 pPCI 并在接下来一周内完成 CMR 的 STEMI 患者。通过 FT 从电影 CMR 中得出 LA 和 LV 纵向应变参数;还进行了常规 CMR 指数。主要终点是主要心血管不良事件(MACE)的发生,定义为死亡、再梗死和充血性心力衰竭(HF)的复合事件。共有 276 名患者(中位年龄 57 岁,IQR 48-66 岁;85%为男性)纳入本研究。CMR 通常在 pPCI 后第 5 天(IQR,4-7 天)完成。在中位随访 16 个月期间,35 名(12.7%)患者发生 MACE。多变量 Cox 回归分析显示,LA 腔应变(HR 0.91,95%CI:0.84,0.98,p = 0.013)和 LV 整体纵向应变(HR 1.17,95%CI:1.03,1.34,p = 0.016)与 MACE 独立相关。LA 腔应变(≤12.8%)和 LV 整体纵向应变(>-13.1%)受损的患者发生 MACE 的风险高于保留的患者。LA 和 LV 的纵向应变可以为 STEMI 患者提供独立的预后信息,全面评估左心房和心室的纵向应变可以显著改善预后。