急性下壁和右壁心肌梗死患者并发症的预测因素

IF 0.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
K. El-Rabat, Reda Bastwesy, N. Elmeligy, S. Farag, Nesreen Zakaria
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引用次数: 0

摘要

引言:早期识别急性右心室心肌梗死(RVMI)对于开始治疗以避免并发症至关重要。目的:本研究的目的是评估急性下壁和右心室心肌梗死患者并发症的预测因素。患者和方法:这项前瞻性的单中心研究包括100名在症状出现后6小时内出现的急性下壁和右心室心肌梗死患者。所有患者均接受链激酶溶栓治疗。患者接受了常规二维超声心动图评估LVEF、RVEF、RVFAC和三尖瓣环平面收缩偏移(TAPSE),组织多普勒评估s’、e’、a’波和心肌性能指数(MPI),斑点跟踪超声心动图用于评估RV整体纵向应变。所有超声心动图参数均在入院前12小时和入院后2个月内完成。结果:在100例急性RVMI患者中;并发症27例,最常见的并发症为房室传导阻滞,其次为心源性休克。只有一名患者死亡。在比较复杂组和非复杂组的入院情况时,我们发现;就临床数据而言,女性、是否患有糖尿病、收缩压和舒张压较低以及脉搏较低是RVMI并发症发生的独立危险因素,分别为P<0.029、0.009、0.004、0.009和0.0001。在入院时的超声心动图参数中,扩张型RV、S侧位、MPI、TAPSE和斑点是RVI患者并发症发生的独立预测因素,分别为P<0.005、<0.0001、0.0001、0.001和0.011。我们可以使用截断值分别为7.9、13.5、0.765、-15.9的横向s’、TAPSE、MPI和散斑来预测急性右心室心肌梗死患者的住院并发症(每个参数的P<0.0001)。结论:在扩张型右心室超声心动图参数中,S侧位、MPI、TAPSE和斑点是右心室心肌梗死患者并发症发生的独立预测因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of complications among patients with acute inferior and right myocardial infarction
Introduction: Early recognition of acute right ventricular myocardial infarction (RVMI) is very crucial for the initiation of treatment to avoid complications. Objective: The objective of this study is to assess the predictors of complications in patients with acute inferior and RVMI. Patients and Methods: This prospective, single-center study included 100 patients with acute inferior and RVMI presented within 6 h of symptoms onset. All patients received streptokinase as thrombolytic therapy. The patients had undergone conventional two-dimensional echocardiography to assess LVEF, RVEF, RVFAC, and tricuspid annular plane systolic excursion (TAPSE), tissue Doppler to assess s', e', a' waves and myocardial performance index (MPI), and speckle tracking echocardiography to assess RV global longitudinal strain. All echocardiographic parameters were done within the first 12 h of admission and 2 months later. Results: Of 100 patients with acute RVMI; 27 patients had complications, the most common complication was atrioventricular block followed by cardiogenic shock. Mortality occurred in only one patient. On comparing the complicated and noncomplicated groups on admission, we revealed that; as regarding the clinical data, the female gender, presence of diabetes, lower systolic and diastolic blood pressure, and lower pulse were independent risk factors for occurrence of complications in RVMI with P < 0.029, 0.009, 0.004, 0.009, and 0.0001, respectively. Of the echo-cardiographic parameters on admission, dilated RV, lateral S, MPI, TAPSE, and speckle were independent predictors for the occurrence of complications in patients with RVI with P < 0.005, <0.0001, 0.0001, 0.0001, and 0.011, respectively. We can use lateral s', TAPSE, MPI, and speckle with cutoff value 7.9, 13.5, 0.765, −15.9, respectively, for prediction of in-hospital complications in acute RVMI patients (P < 0.0001 for each parameter). Conclusion: Of the echo-cardiographic parameters dilated RV, lateral S, MPI, TAPSE, and speckle were independent predictors for the occurrence of complications in patients with RVMI.
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来源期刊
Research in Cardiovascular Medicine
Research in Cardiovascular Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-
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审稿时长
17 weeks
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