非 ST 段抬高型心肌梗死患者心肌早期收缩期延长与高危血管造影区域受累之间的关系。

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Ultrasound Pub Date : 2024-09-01 Epub Date: 2024-03-29 DOI:10.1007/s40477-024-00885-w

Maryam Nabati, Saeed Kavousi, Jamshid Yazdani, Homa Parsaee

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引用次数: 0

摘要

背景：非 ST 段抬高型心肌梗死（NSTEMI）比 ST 段抬高型心肌梗死（STEMI）更常见，占心肌梗死的 60-70%。当左心室（LV）压力在收缩早期增加时，主动力降低的区域性缺血心肌会出现伸展。本研究旨在评估该参数在确定 NSTEMI 患者高风险血管造影区域受累方面的作用：本研究是一项描述性相关研究，对 96 名左心室射血分数≥ 50%、接受冠状动脉造影术（CAG）的 NSTEMI 患者进行了研究。根据 CAG 是否累及高危血管区域将患者分为两组。所有患者在住院第一天都接受了经胸超声心动图检查，并测定了早期收缩期延长（ESL）、ESL持续时间（DESL）、左室整体纵向应变（LVGLS）、脉冲波多普勒衍生的透射瓣早期（E波）和晚期（A波）舒张速度，以及组织多普勒衍生的二尖瓣环早期舒张（e'）和峰值收缩（s'）速度。研究结果显示，高危血管区域组的 DESL、DESLLAD 和 DESLLCX 比其他组长（P 值分别为 0.016、0.044 和 0.04）。逻辑回归分析显示，在不同变量中，只有年龄和 ESLLAD 与高风险血管造影区域受累有独立关联（分别为 P = 0.01，几率比 [OR] 1.09，95% CI 1.021-1.164 和 P = 0.024，几率比 [OR] 1.243，95% CI 1.029-1.50）：结论：通过斑点追踪超声心动图评估心肌ESLLAD可能有助于预测NSTEMI患者血管受累的高风险区域。事实上，较高的数值可被视为高风险参数，可显示早期介入策略相对于保守方法的益处。

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The association between myocardial early systolic lengthening and high risk angiographic territory involvement in patients with non-ST-segment elevation myocardial infarction.

Background: Non-ST-segment elevation myocardial infarction (NSTEMI) is more common than ST-segment elevation myocardial infarction (STEMI), consisting of 60-70% of myocardial infarctions. When left ventricular (LV) pressure increases during early systole, regionally ischaemic myocardium with a reduced active force exhibit stretching. The aim of this study was to evaluate the role of this parameter in determining high risk angiographic territory involvement in NSTEMI patients.

Results: This study was a descriptive correlational research that was conducted on 96 patients with NSTEMI and a left ventricular ejection fraction ≥ 50% who underwent coronary angiography (CAG). Patients were divided into two groups based on having or not having high risk angiographic territory involvement in CAG. All patients underwent a transthoracic echocardiography during the first day of hospitalization and early systolic lengthening (ESL), duration of ESL (DESL), left ventricular global longitudinal strain (LVGLS), pulsed-wave Doppler-derived transmitral early (E wave) and late (A wave) diastolic velocities, and tissue-Doppler-derived mitral annular early diastolic (e') and peak systolic (s') velocities were determined. The results of this study showed DESL, DESL_LAD, and DESL_LCX were longer in high risk angiographic territory group than other one (P value 0.016, 0.044, and 0.04, respectively). The logistic regression analysis showed among different variables, only age and ESL_LAD had an independent association with high risk angiographic territory involvement (P = 0.01, odds ratio [OR] 1.09, 95% CI 1.021-1.164, and P = 0.024, odds ratio [OR] 1.243, 95% CI 1.029-1.50, respectively).

Conclusions: Assessment of myocardial ESL_LAD by speckle-tracking echocardiography may be helpful in predicting high risk angiographic territory involvement in patients with NSTEMI. Indeed, a higher value can be considered as a high risk parameter which may show benefit of an early invasive strategy versus a conservative approach.

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来源期刊

Journal of Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.10

自引率

15.00%

发文量

133

期刊介绍： The Journal of Ultrasound is the official journal of the Italian Society for Ultrasound in Medicine and Biology (SIUMB). The journal publishes original contributions (research and review articles, case reports, technical reports and letters to the editor) on significant advances in clinical diagnostic, interventional and therapeutic applications, clinical techniques, the physics, engineering and technology of ultrasound in medicine and biology, and in cross-sectional diagnostic imaging. The official language of Journal of Ultrasound is English.