Oleynikov Valentin, Salyamova Lyudmila, Alimov Nikolay, Donetskaya Natalia, Avdeeva Irina, Averyanova Elena
Therapy Department, Penza State University, 40, Krasnaya St., 440026 Penza, Russia.
Regional Clinical Hospital n/a N.N. Burdenko, 28, Lermontova St., 440026 Penza, Russia.
Diagnostics (Basel). 2025 Jun 25;15(13):1611. doi: 10.3390/diagnostics15131611.
: The aim of this study is to identify markers and develop a multifactorial model for characterizing extensive scar tissue after revascularization in patients with myocardial infarction (MI). : A total of 123 patients with MI were examined. The patients underwent contrast-enhanced cardiac magnetic resonance imaging (MRI) with a 1.5 Tesla GE SIGNA Voyager (GE HealthCare, Chicago, IL, USA) on the 7th-10th days from the onset of the disease. At the first stage, we performed a comparative analysis and built a multifactorial model based on the examination results of 92 (75%) patients enrolled from April 2021 to October 2023. These patients formed the group used for model development, or the "modeling group". The mass of the scar was calculated, including relative to the left ventricular (LV) myocardium mass (M/LVMM, in %). : The first subgroup consisted of 36 (39%) patients with a large scar, denoted as "LS" (M/LVMM > 20%). The second subgroup included 56 (61%) patients with a smaller scar, referred to as "SS" (M/LVMM ≤ 20%). Logistic regression was used to identify independent factors affecting scar tissue size. A multifactorial model was created. This model predicts M/LVMM > 20% on MRI. It uses readily available clinical parameters: high-sensitivity troponin I (HscTn I) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and LV relative wall thickness (RWT). We tested the multifactorial model on the "modeling group" ( = 31). The sensitivity was 63.6% and the specificity was 85.7%. : These indicates the feasibility of its application in clinical practice.
本研究的目的是识别标志物并建立一个多因素模型，用于表征心肌梗死（MI）患者血管重建术后的广泛瘢痕组织。总共对123例MI患者进行了检查。患者在疾病发作后的第7至10天接受了使用1.5特斯拉GE SIGNA Voyager（GE医疗保健公司，美国伊利诺伊州芝加哥）的对比增强心脏磁共振成像（MRI）检查。在第一阶段，我们进行了比较分析，并根据2021年4月至2023年10月纳入的92例（75%）患者的检查结果建立了一个多因素模型。这些患者组成了用于模型开发的组，即“建模组”。计算瘢痕质量，包括相对于左心室（LV）心肌质量（M/LVMM，以%表示）。第一个亚组由36例（39%）有大瘢痕的患者组成，记为“LS”（M/LVMM>20%）。第二个亚组包括56例（61%）有较小瘢痕的患者，称为“SS”（M/LVMM≤20%）。使用逻辑回归来识别影响瘢痕组织大小的独立因素。创建了一个多因素模型。该模型在MRI上预测M/LVMM>20%。它使用易于获得的临床参数：高敏肌钙蛋白I（HscTn I）和N末端前B型利钠肽（NT-proBNP）水平，以及LV相对壁厚度（RWT）。我们在“建模组”（n = 31）上测试了多因素模型。敏感性为63.6%，特异性为85.7%。这些表明了其在临床实践中应用的可行性。
