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ST段抬高型心肌梗死患者左心室射血分数低于35%时左心室射血分数改善的超声心动图预测指标

Echocardiographic Predictors of Improvement of Left Ventricular Ejection Fraction below 35% in Patients with ST-Segment Elevation Myocardial Infarction.

作者信息

Shmueli Hezzy, Tsaban Gal, Moreno Anna, Shamia David, Weissberg Itai, Uziel David, Star Artyom, Elhaj Khaled, Abramowitz Yigal

机构信息

Cardiology Department, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, P.O. Box 151, Beer Sheva 84101, Israel.

出版信息

J Clin Med. 2024 Jul 9;13(14):4016. doi: 10.3390/jcm13144016.

Abstract

: An ST-elevation myocardial infarction (STEMI) is a clinical syndrome defined by symptoms of myocardial ischemia, persistent electrocardiographic ST-segment elevation and subsequent release of biomarkers suggestive of myocardial necrosis. In clinical practice, echocardiography has become essential in evaluating patients after acute myocardial infarction. We aimed to assess clinical and echocardiographic parameters that may affect LV function recovery in patients after STEMI. : This study is a retrospective observational study from a tertiary referral center in Israel. We collected patients that were admitted with STEMI and a left ventricular ejection fraction (LVEF) below 35% on preliminary echocardiography at the index hospitalization and compared the findings to a follow-up study performed within 1-6 months after that event, in order to see if there are predictors of LVEF change > 10% within 90 days following STEMI. : This study included 101 patients that were admitted between 2016 and 2021. Within a median follow-up of 9.7 weeks (IQR 5.9-17.1), 27 (25.2%) patients had improved their LVEF, and 74 (69.2%) had no change or further reduced LVEF. Compared to patients without LVEF improvement, those with improved LVEF were more likely to be female (29.6% vs. 9.5%, = 0.01), less likely to suffer from hypertension (33.3% vs. 56.8%, = 0.04) and had marginally higher rates of thrombolysis treatment (14.1% vs. 4.1%, = 0.06). : in the population of STEMI patients with residual LVEF < 35%, approximately a quarter will improve at least 10% in their follow-up LVEF, and there were no clear echocardiographic predictors for this improvement.

摘要

ST段抬高型心肌梗死(STEMI)是一种临床综合征,由心肌缺血症状、持续的心电图ST段抬高以及随后提示心肌坏死的生物标志物释放所定义。在临床实践中,超声心动图已成为评估急性心肌梗死后患者的重要手段。我们旨在评估可能影响STEMI后患者左心室功能恢复的临床和超声心动图参数。 :本研究是一项来自以色列一家三级转诊中心的回顾性观察研究。我们收集了因STEMI入院且在首次住院时初步超声心动图显示左心室射血分数(LVEF)低于35%的患者,并将这些结果与该事件发生后1至6个月内进行的随访研究结果进行比较,以观察是否存在STEMI后90天内LVEF变化>10%的预测因素。 :本研究纳入了2016年至2021年间入院的101例患者。在中位随访9.7周(四分位间距5.9 - 17.1)内,27例(25.2%)患者的LVEF有所改善,74例(69.2%)患者的LVEF无变化或进一步降低。与LVEF未改善的患者相比,LVEF改善的患者更可能为女性(29.6%对9.5%,P = 0.01),患高血压的可能性较小(33.3%对56.8%,P = 0.04),溶栓治疗率略高(14.1%对4.1%,P = 0.06)。 :在残余LVEF<35%的STEMI患者群体中,约四分之一的患者在随访LVEF时至少改善10%,且对于这种改善没有明确的超声心动图预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f02f/11277829/bdee152b63b7/jcm-13-04016-g001.jpg

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