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[面积应变作为心肌梗死功能恢复的预后因素]

[Area strain as prognostic factor of functional recovering in myocardial infarction].

作者信息

Ahumada-Pérez Joaquín, Moreno-Ruíz Luis Antonio, García-Cosío Carlos, Silvestre-Flores Ivan, Ruíz-Rivera Antonio, Zamorano-Velázquez Noe Fernando, Villanueva-López Guadalupe Cleva

机构信息

Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Cardiología, Servicio de Gabinetes. Ciudad de México, México.

Instituto Politécnico Nacional, Escuela Superior de Medicina, Departamento de Posgrado e Investigación. Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2025 Mar 3;63(2):e6591. doi: 10.5281/zenodo.14617002.

Abstract

BACKGROUND

Area strain evaluates the longitudinal and circumferential deformation simultaneously. There are not estudies that support its benefit in predicting functional recovering in myocardial infarction.

OBJECTIVE

The aim was establish the prognostic value of the area strain measured within the first 7 days after succesful angioplasty to predicting functional recovering.

MATERAIL AND METHODS

A prospective cohort study was performed during 3-month follow-up. Patients with myocardial infarction treated with succesful angioplasty were enrolled. The area strain was perfomed within the first 7 days. Functional recovering was defined as an improvement of the ejection fraction ≥ 10% at 3-months follow-up.

RESULTS

A total of 52 patients were enrolled. An area strain of ≤ -24.2 % appeared in the 45.5% of the patients with functional recovering, RR 16.25 (IC 95%: 2.55-103, p = 0.003). In the multivariate analyses the area strain of ≤ -24.2 % was the only variable with statistical significance with an OR of 13.15 (IC 95%: 1.83-94, p = 0.010) when was adjusted to hypertension, OR of 12.7 (IC 95%: 1.88-85.9, p = 0.009) adjusted to reperfusion time of ≤ 120 minutes and the OR was of 11.87 (IC 95%: 1.66-84.5, p = 0.013) adjusted to smoking.

CONCLUSIONS

An area strain of ≤ - 24.2% is a prognostic factor of improvement of ejection fraction of ≥ 10% at 3-months follow-up in patients with myocardial infarction and succesful angioplasty.

摘要

背景

面积应变可同时评估纵向和圆周方向的变形。尚无研究支持其在预测心肌梗死功能恢复方面的益处。

目的

旨在确定成功血管成形术后7天内测量的面积应变对预测功能恢复的预后价值。

材料与方法

进行了一项为期3个月随访的前瞻性队列研究。纳入成功接受血管成形术治疗的心肌梗死患者。在最初7天内进行面积应变测量。功能恢复定义为在3个月随访时射血分数提高≥10%。

结果

共纳入52例患者。45.5%功能恢复的患者出现面积应变≤-24.2%,相对危险度为16.25(95%置信区间:2.55-103,p=0.003)。在多变量分析中,当调整高血压时,面积应变≤-24.2%是唯一具有统计学意义的变量,比值比为13.15(95%置信区间:1.83-94,p=0.010);调整再灌注时间≤120分钟时,比值比为12.7(95%置信区间:1.88-85.9,p=0.009);调整吸烟情况时,比值比为11.87(95%置信区间:1.66-84.5,p=0.013)。

结论

面积应变≤-24.2%是心肌梗死且成功接受血管成形术患者在3个月随访时射血分数提高≥10%的预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c75/12043351/d776cbc3d12c/04435117-63-2-e6591-c001.jpg

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