2D-STI联合动态心电图对急性心肌梗死患者预后结局的评估

doi:10.7517/issn.1674-0475.220715

摘要/Abstract

摘要： 本研究探讨二维斑点追踪技术(2D-STI)联合动态心电图评估急性心肌梗死(AMI)患者预后结局的价值。选取采用经皮冠脉介入术(PCI)治疗的AMI患者作为研究对象,所有患者术后随访1年,选取其中47例发生主要不良心血管事件(MACE)的患者作为MACE组、另外80例未发生MACE的患者作为对照组。两组患者术前均接受动态心电图及2D-STI检查,分析两组患者的动态心电图及2D-STI指标差异,并采用Logistic模型分析各项指标与MACE的关系。MACE组患者的动态心电图指标NN间期标准差(SDNN)、震荡斜率(TS)测定值均低于对照组,震荡起始(TO)测定值大于对照组(P<0.05)。左心房最大容积(LAVmax)、左心房最小容积(LAVmin)、左心房收缩前容积(LAVp)测定值均大于对照组。左心房主动射血分数(LAAEF)、左心房被动射血分数(LAPEF)、左心房收缩期平均峰值应变率(mSRs)、左心房舒张早期平均峰值应变率(mSRe)、左心房舒张晚期平均峰值应变率(mSRa)、左心房平均峰值应变率(mSs)测定值低于对照组(P<0.05)。通过观察AMI患者PCI术前的动态心电图参数、2D-STI参数,可在一定程度上对PCI患者术后MACE发生风险进行早期评估,有利于患者的早期预防性治疗。

关键词: 二维斑点追踪技术, 动态心电图, 急性心肌梗死, 预后, 不良心血管事件

Abstract: This study investigated the value of two-dimensional speckle tracking (2D-STI) combined with dynamic electrocardiography in evaluating the prognosis of patients with acute myocardial infarction (AMI). AMI patients treated with percutaneous coronary intervention (PCI) were selected as the research subjects. All patients were followed up for 1 year after surgery. Among them, 47 patients with major adverse cardiovascular events (MACE) were selected as the MACE group, and the other 80 patients without patients with MACE served as a control group. The two groups of patients received dynamic ECG and 2D-STI examinations before operation, and the differences in the dynamic ECG and 2D-STI indexes of the two groups were analyzed, and the relationship between each index and MACE was analyzed by Logistic model. The dynamic electrocardiogram index standard deviation of NN interval (SDNN) and oscillation slope (TS) in the MACE group were lower than those in the control group, and the measured value of shock onset (TO) was greater than that in the control group (P<0.05). The values of left atrial maximum volume (LAVmax), left atrial minimum volume (LAVmin) and left atrial presystolic volume (LAVp) were higher than those of the control group. Left atrial active ejection fraction (LAAEF),Passive ejection fraction (LAPEF), left atrial systolic mean peak strain rate (mSRs), left atrial mean early diastolic strain rate (mSRe), left atrial late diastolic mean peak strain rate (mSRa), left atrial mean peak strain rate (mSs) measured value were lower than those of the control group (P<0.05). By observing the dynamic ECG parameters and 2D-STI parameters before PCI in AMI patients, early assessment of the risk of MACE after PCI can be carried out to a certain extent, which is beneficial to the early preventive treatment of patients.

Key words: two dimensional speckle tracking technology, dynamic ECG, acute myocardial infarction, prognosis, major adverse cardiovascular events

王丽娟, 李伦伦, 杨琳琳. 2D-STI联合动态心电图对急性心肌梗死患者预后结局的评估[J]. 影像科学与光化学, 2022, 40(6): 1513-1518.

WANG Lijuan, LI Lunlun, YANG Linlin. Evaluation of Prognostic Outcomes in Patients with Acute Myocardial Infarction by 2D-STI Combined with Dynamic Electrocardiogram[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(6): 1513-1518.

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