对比增强心脏磁共振成像显示的微血管阻塞在评估急性 ST 段抬高型心肌梗死患者预后中的价值

Q3 Medicine

Russian Journal of Cardiology Pub Date : 2024-04-18 DOI:10.15829/1560-4071-2024-5603

M. Terenicheva, R. Shakhnovich, O. V. Stukalova, D. V. Pevzner, I. Yavelov, Y.O. Shalaginova, S. K. Ternovoy

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Patients with MVO had a significantly lower LVEF in the acute period of MI (44,1±10,6%) compared to patients without MVO (52,9±10,5%), p=0,0209, as well as during reassessment after a year (44,8±11,1%) compared with patients without MVO (58,9±8,0%), p=0,0004. A significant inverse correlation was found between LVEF in the initial and repeat examination and MVO size in the initial examination as follows: ρ=-0,42 (95% confidence interval (CI): -0,66 — -0,12, p=0,008) and ρ=-0,61 (95% CI: -0,78 — -0,34, p=0,0001). There was also a significant inverse correlation between LVEF and MVO size at reassessment, ρ=-0,40 (95% CI: -0,65 — -0,07, p=0,0205). A significant direct correlation was identified between MVO size in the acute MI period and LVEDV one year later, ρ=0,35 (95% CI: 0,02-0,62, p=0,0409). The development of a left ventricular (LV) aneurysm was registered in 40% of patients with MVO during the initial study and was not registered among patients without MVO (p=0,0039).Conclusion. 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引用次数: 0

摘要

目的研究微血管阻塞（MBO）的存在和大小与一年内接受初级经皮冠状动脉介入治疗（PPCI）的ST段抬高型急性心肌梗死（STEMI）患者预后之间的关系。研究纳入了 50 名首次 STEMI 患者，他们都在梗死相关动脉上接受了经皮冠状动脉介入治疗。3-7 天和 12 个月后，进行对比增强心脏磁共振成像，以评估左心室射血分数（LVEF）、左心室舒张末期容积（LVEDV）和 MVO。12 个月后，患者再次入院，并根据心血管事件数据评估预后。在心肌梗死急性期（44.1±10.6%），MVO 患者的 LVEF 明显低于无 MVO 患者（52.9±10.5%），P=0.0209；在一年后的复查中（44.8±11.1%），MVO 患者的 LVEF 也明显低于无 MVO 患者（58.9±8.0%），P=0.0004。初次检查和复查时的 LVEF 与初次检查时的 MVO 大小呈明显的负相关：ρ=-0,42（95% 置信区间 (CI)：-0,66 - -0,12，p=0,008）和 ρ=-0,61 （95% 置信区间 (CI)：-0,78 - -0,34，p=0,0001）。LVEF 与再次评估时的 MVO 大小之间也存在明显的反相关性，ρ=-0,40（95% CI：-0,65 - 0,07，P=0,0205）。急性心肌梗死期间的 MVO 大小与一年后的 LVEDV 之间存在明显的直接相关性，ρ=0,35（95% CI：0,02-0,62，p=0,0409）。在最初的研究中，40% 的 MVO 患者出现了左心室（LV）动脉瘤，而没有 MVO 的患者则没有出现动脉瘤（P=0,0039）。MVO与梗死后左心室动脉瘤有关。在急性期和心肌梗死一年后，MVO 大小的增加与 LVEF 的下降和 LVEDV 的增加相关。

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The value of microvascular obstruction according to contrast-enhanced cardiac magnetic resonance imaging in assessing the prognosis of patients with acute ST-segment elevation myocardial infarction

Aim. To study the relationship between the presence and size of microvascular obstruction (MVO) and the prognosis of patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) within one year.Material and methods. The study included 50 patients with a first STEMI who underwent PPCI on the infarct-related artery. After 3-7 days and 12 months, contrast-enhanced cardiac magnetic resonance imaging was performed to assess left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), and MVOs. After 12 months, patients were rehospitalized and prognosis was assessed based on data on cardiovascular events.Results. Patients with MVO had a significantly lower LVEF in the acute period of MI (44,1±10,6%) compared to patients without MVO (52,9±10,5%), p=0,0209, as well as during reassessment after a year (44,8±11,1%) compared with patients without MVO (58,9±8,0%), p=0,0004. A significant inverse correlation was found between LVEF in the initial and repeat examination and MVO size in the initial examination as follows: ρ=-0,42 (95% confidence interval (CI): -0,66 — -0,12, p=0,008) and ρ=-0,61 (95% CI: -0,78 — -0,34, p=0,0001). There was also a significant inverse correlation between LVEF and MVO size at reassessment, ρ=-0,40 (95% CI: -0,65 — -0,07, p=0,0205). A significant direct correlation was identified between MVO size in the acute MI period and LVEDV one year later, ρ=0,35 (95% CI: 0,02-0,62, p=0,0409). The development of a left ventricular (LV) aneurysm was registered in 40% of patients with MVO during the initial study and was not registered among patients without MVO (p=0,0039).Conclusion. MVOs was associated with post-infarction LV aneurysm. An increase in MVO size correlated with a decrease in LVEF and an increase in LVEDV both in the acute period and one year after MI.

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来源期刊

Russian Journal of Cardiology Medicine-Cardiology and Cardiovascular Medicine

CiteScore

2.20

自引率

0.00%

发文量

185

审稿时长

1 months

期刊介绍： Russian Journal of Cardiology has been issued since 1996. The language of this publication is Russian, with tables of contents and abstracts of all articles presented in English as well. Editor-in-Chief: Prof. Eugene V.Shlyakhto, President of the Russian Society of Cardiology. The aim of the journal is both scientific and practical, also with referring to organizing matters of the Society. The best of all cardiologic research in Russia is submitted to the Journal. Moreover, it contains useful tips and clinical examples for practicing cardiologists. Journal is peer-reviewed, with multi-stage editing. The editorial board is presented by the leading cardiologists from different cities of Russia.