Omari Muntaser, James Natasha, Brown Andrew, Kadhim Kadhim, Bawamia Bilal, McDiarmid Adam, Alkhalil Mohammad
Freeman Hospital Cardiothoracic Centre, Newcastle upon Tyne, UK.
Freeman Hospital Cardiothoracic Centre, Newcastle upon Tyne, UK
Open Heart. 2025 Sep 5;12(2):e003429. doi: 10.1136/openhrt-2025-003429.
Stroke volume is an established echocardiographic marker but has not been widely studied in patients with ST-segment elevation myocardial infarction (STEMI). We aimed to evaluate stroke volume in a cohort of uncomplicated anterior STEMI and to assess its prognostic role in those with severe left ventricle (LV) systolic dysfunction.
This is a single-centre retrospective analysis of consecutive patients presenting with anterior STEMI who underwent uncomplicated primary percutaneous coronary intervention. Stroke volume was measured using echocardiography within in-hospital admission. The primary endpoint was cardiovascular mortality. Of 3592 patients with STEMI, 616 were included. The mean age was 65±14 years (76% males). The average left ventricular ejection fraction (LVEF) and stroke volume were 39±11% and 62±18 mL, respectively. There was a modest relationship between stroke volume and LVEF (r=0.33, p<0.001), which was not maintained in patients with severe LV dysfunction (r=0.11, p=0.19). On multivariate analysis, stroke volume was associated with cardiovascular death at 12 months (HR 0.92, 95% CI 0.86 to 0.98, p=0.015) in patients with severe LV systolic dysfunction. Receiver operating characteristic analysis demonstrated an area under the curve of 0.80 (95% CI 0.70 to 0.91, p<0.001) in this group with negative predictive value of 99% for cardiovascular mortality.
Stroke volume is a readily and useful echocardiographic marker to assess prognosis in patients with anterior STEMI and severe LV systolic dysfunction. It identifies with a high degree of certainty those patients who are likely to survive despite their severe LV systolic dysfunction.
每搏输出量是一种既定的超声心动图指标，但在ST段抬高型心肌梗死（STEMI）患者中尚未得到广泛研究。我们旨在评估一组无并发症的前壁STEMI患者的每搏输出量，并评估其在严重左心室（LV）收缩功能障碍患者中的预后作用。
这是一项对连续出现前壁STEMI并接受无并发症直接经皮冠状动脉介入治疗的患者进行的单中心回顾性分析。在住院期间使用超声心动图测量每搏输出量。主要终点是心血管死亡率。在3592例STEMI患者中，616例被纳入研究。平均年龄为65±14岁（76%为男性）。平均左心室射血分数（LVEF）和每搏输出量分别为39±11%和62±18ml。每搏输出量与LVEF之间存在适度相关性（r=0.33，p<0.001），但在严重LV功能障碍患者中这种相关性未得到维持（r=0.11，p=0.19）。多因素分析显示，在严重LV收缩功能障碍患者中，每搏输出量与12个月时的心血管死亡相关（HR 0.92，95%CI 0.86至0.98，p=0.015）。受试者工作特征分析显示，该组曲线下面积为0.80（95%CI 0.70至0.91，p<0.001），心血管死亡率的阴性预测值为99%。
每搏输出量是评估前壁STEMI和严重LV收缩功能障碍患者预后的一种便捷且有用的超声心动图指标。它能高度准确地识别出那些尽管存在严重LV收缩功能障碍但仍可能存活的患者。
