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目的观察急性ST段抬高型心肌梗死(STEMI)患者介入治疗(PCI)后6个月左心室整体纵向应变(GLS)及心肌梗死面积(IS)的变化,并探讨二者与PCI术后6~12个月主要不良心血管事件(MACE)发生情况的关系。方法选择60例PCI术后STEMI患者(其中7例PCI术后6~12个月发生MACE)。PCI术后7 d、6个月分别采用二维超声心动图斑点追踪成像技术测算左心室GLS,采用延迟增强心磁共振技术测算左心室IS。结果本组患者PCI术后7 d、6个月左心室GLS分别为-14%±3%、-17%±3%,IS分别为23%±7%、19%±6%。本组患者PCI术后6个月左心室GLS、IS均低于术后7 d,P均<0.05。相关性分析显示,本组患者PCI术后左心室GLS和IS呈负相关(r=-0.756,P<0.01)。本组患者PCI术后6个月左心室GLS较术后7 d降低2%~4%,中位数为3%。以PCI术后6个月左心室GLS较术后7 d降低幅度的中位数为界值将本组患者分为GLS明显降低组(降低幅度≥中位数)26例和GLS无明显降低组(降低幅度<中位数)34例,其中分别有0、7例患者随访过程中发生MACE,两组MACE发生率相比,P<0.05。本组患者PCI术后6个月IS较术后7 d降低2%~5%,中位数为3%。以PCI术后6个月IS较术后7 d降低幅度的中位数为界值将本组患者分为IS明显降低组(降低幅度≥中位数)21例和IS无明显降低组(降低幅度<中位数)39例,其中分别有0、7例患者随访过程中发生MACE,两组MACE发生率相比,P<0.05。结论 STEMI患者PCI术后6个月左心室GLS和IS低于术后7 d;STEMI患者PCI术后左心室GLS、IS有较好的相关性;STEMI患者PCI术后左心室GLS、IS明显降低者不易发生MACE。
Objective To observe the change of left ventricular total longitudinal strain (GLS) and myocardial infarct size (IS) at 6 months after PCI in acute ST-segment elevation myocardial infarction (STEMI) ~ 12 months major adverse cardiovascular events (MACE) the incidence of the situation. Methods Sixty patients with STEMI after PCI were selected. Among them, MACE occurred in 6 of 12 patients after PCI in 7 patients. Left ventricular GLS was measured by two-dimensional echocardiographic speckle tracking imaging at 7 days and 6 months after PCI, and left ventricular IS was measured by delayed-enhanced cardiac magnetic resonance imaging. Results The left ventricular GLS were -14% ± 3% and -17% ± 3% at 7 days and 6 months after PCI respectively. The ISs were 23% ± 7% and 19% ± 6% respectively. The left ventricular GLS, IS of 6 months after PCI in this group were lower than those of 7 days after PCI, P <0.05. Correlation analysis showed that left ventricular GLS and IS were negatively correlated in this group (r = -0.756, P <0.01). This group of patients 6 months after PCI left ventricular GLS decreased 7% after 2 days to 4%, the median was 3%. Six patients with left ventricular GLS at 6 months after PCI than the 7th day after the median decrease in the median for this group were divided into GLS significantly reduced group (reduction ≥ median) 26 cases and no significant reduction in GLS group (Median reduction) of 34 patients, including 0 and 7 patients with MACE during follow-up, respectively. The incidence of MACE in both groups was significantly lower than that in patients with MACE (P <0.05). The 6 months after PCI in our group was 2% ~ 5% lower than 7 days after operation, with a median of 3%. The IS patients at 6 months after PCI were divided into IS group (21 cases) with reduced IS (median decrease) and IS group (no significant decrease) Amplitude, median) 39 cases, of which 0,7 cases were followed up MACE, the incidence of MACE in both groups, P <0.05. Conclusions Left ventricular GLS and IS in STEMI patients at 6 months after PCI are lower than those at 7 days after PCI. Left ventricular GLS and IS in STEMI patients after PCI are correlated well. Left ventricular GLS and IS in STEMI patients after PCI are significantly lower MACE less prone.