Wang Yanbo, Zhou Qing, Su Lifang, Miao Yajing, Wang Xiaoxu, Jiang Yunfa, Gu Xinshun, Yin Hongning
The Fifth Department of Cardiology, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.
Department of Echocardiography, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.
Am Heart J Plus. 2025 Jul 12;57:100578. doi: 10.1016/j.ahjo.2025.100578. eCollection 2025 Sep.
Despite successful reperfusion therapy, a subset of patients with ST-segment elevation myocardial infarction (STEMI) experience early left ventricular remodeling (LVR) within 72 h of symptom onset. LVR is associated with poor outcomes, whereas LV reverse remodeling (LVRR) is correlated with favorable prognosis. This study investigated the factors associated with early LVR and LVRR in STEMI patients.
We enrolled 233 consecutive STEMI patients who successfully underwent reperfusion therapy within 12 h of symptom onset between April 2022 to January 2024. They were categorized into non-LVR ( = 135) and early LVR ( = 98) groups based on their LV ejection fraction (LVEF). The early LVR group patients were categorized into LVRR ( = 46) and non-LVRR ( = 52) subgroups based on the LVEF values at 5-7 days after symptom onset. Logistic regression models were used to identify the predictive factors associated with early LVR and LVRR.
Multivariate analysis showed that the admission heart rate (HR) (odds ratio [OR] = 2.965, = 0.005), peak creatine kinase MB (CK-MB) level (OR = 6.166, < 0.001), fasting plasma glucose (FPG) concentration (OR = 3.608, = 0.002), and perfusion score index (PSI) (OR = 91.976, < 0.001) were independent predictive factors for early LVR. Moreover, pericardial effusion (PE) and PSI within 72 h of symptom onset were predictive factors for failure of LVRR.
Our data showed that admission HR, CK-MB peak level, FPG concentration, and PSI were independent predictive factors for early LVR, whereas PE and PSI were predictive factors for failure of LVRR in STEMI patients.
尽管再灌注治疗取得成功，但一部分ST段抬高型心肌梗死（STEMI）患者在症状发作72小时内出现早期左心室重构（LVR）。LVR与不良预后相关，而左心室逆向重构（LVRR）与良好预后相关。本研究调查了STEMI患者早期LVR和LVRR的相关因素。
我们纳入了2022年4月至2024年1月期间在症状发作12小时内成功接受再灌注治疗的233例连续STEMI患者。根据左心室射血分数（LVEF）将他们分为非LVR组（n = 135）和早期LVR组（n = 98）。早期LVR组患者根据症状发作后5 - 7天的LVEF值分为LVRR亚组（n = 46）和非LVRR亚组（n = 52）。采用逻辑回归模型确定与早期LVR和LVRR相关的预测因素。
多变量分析显示，入院心率（HR）（比值比[OR] = 2.965，P = 0.005）、肌酸激酶MB（CK - MB）峰值水平（OR = 6.166，P < 0.001）、空腹血糖（FPG）浓度（OR = 3.608，P = 0.002）和灌注评分指数（PSI）（OR = 91.976，P < 0.001）是早期LVR的独立预测因素。此外，症状发作72小时内的心包积液（PE）和PSI是LVRR失败的预测因素。
我们的数据表明，入院HR、CK - MB峰值水平、FPG浓度和PSI是STEMI患者早期LVR的独立预测因素，而PE和PSI是STEMI患者LVRR失败的预测因素。
