{"title":"利用斑点跟踪超声心动图观察STEMI患者的纵向应变。与梗死峰值质量和射血分数的相关性","authors":"Amira M. Ismail, Wael Samy, Randa Aly, Suzy Fawzy, Khaled Hussein","doi":"10.1016/j.ejccm.2015.10.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><p>Our objective was to assess the global longitudinal peak systolic strain (GLPSS) by speckle tracking echocardiography (STE) in patients with STEMI in the first 24<!--> <!-->h after primary percutaneous coronary intervention (PCI) and its correlation with LV infarction size and ejection fraction.</p></div><div><h3>Methods and results</h3><p>A total of 30 patients with STEMI (mean age: 58<!--> <!-->±<!--> <!-->8<!--> <!-->years, 25 men) were studied. All patients underwent 1ry PCI. Conventional 2D echocardiography was performed to assess left ventricular ejection fraction (LVEF), wall motion score index (WMSI), and end systolic volume index (ESVI), while STE was performed within 24<!--> <!-->h of 1ry PCI to assess LV GLPSS. Infarction size was estimated by myocardial perfusion imaging before hospital discharges. All patients with STEMI had low LV GLPSS (mean: −10.57<!--> <!-->±<!--> <!-->2.67%). Significant inverse correlation was observed between LV GLPSS and IS (<em>p</em> <!-->=<!--> <!-->0.03, <em>r</em> <!-->=<!--> <!-->0.39) with the cut-off point for GLPSS, which defined large myocardial infarction size (⩾30% of LV mass), was −11.5% with 93% sensitivity and 67% specificity (AUC<!--> <!-->=<!--> <!-->0.8). Also LV GLPSS proportionally correlated with EF (<em>p</em> <!-->=<!--> <!-->0.01, <em>r</em> <!-->=<!--> <!-->0.35) and inversely correlated with WMSI (<em>p</em> <!-->=<!--> <!-->0.04, <em>r</em> <!-->=<!--> <!-->0.5). WMSI showed the most significant correlation to IS (<em>p</em> <!-->=<!--> <!-->0.0, <em>r</em> <!-->=<!--> <!-->0.64). Significant correlation was observed between IS and EF (<em>p</em> <!-->=<!--> <!-->0.04, <em>r</em> <!-->=<!--> <!-->0.37). No significant correlation was found neither between ESVI and IS (<em>p</em> <!-->=<!--> <!-->0.4, <em>r</em> <!-->=<!--> <!-->0.2) nor GLPSS (<em>p</em> <!-->=<!--> <!-->0.08, <em>r</em> <!-->=<!--> <!-->0.33).</p></div><div><h3>Conclusions</h3><p>Assessment of IS by echocardiography after PCI in patients with STEMI was superior with GLS and WMSI when compared with LVEF and ESVI. Since global strain is an inexpensive test, these data may be of health economic interest.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.3000,"publicationDate":"2015-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2015.10.002","citationCount":"5","resultStr":"{\"title\":\"Longitudinal strain in patients with STEMI using speckle tracking echocardiography. Correlation with peak infarction mass and ejection fraction\",\"authors\":\"Amira M. Ismail, Wael Samy, Randa Aly, Suzy Fawzy, Khaled Hussein\",\"doi\":\"10.1016/j.ejccm.2015.10.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aim</h3><p>Our objective was to assess the global longitudinal peak systolic strain (GLPSS) by speckle tracking echocardiography (STE) in patients with STEMI in the first 24<!--> <!-->h after primary percutaneous coronary intervention (PCI) and its correlation with LV infarction size and ejection fraction.</p></div><div><h3>Methods and results</h3><p>A total of 30 patients with STEMI (mean age: 58<!--> <!-->±<!--> <!-->8<!--> <!-->years, 25 men) were studied. All patients underwent 1ry PCI. Conventional 2D echocardiography was performed to assess left ventricular ejection fraction (LVEF), wall motion score index (WMSI), and end systolic volume index (ESVI), while STE was performed within 24<!--> <!-->h of 1ry PCI to assess LV GLPSS. Infarction size was estimated by myocardial perfusion imaging before hospital discharges. All patients with STEMI had low LV GLPSS (mean: −10.57<!--> <!-->±<!--> <!-->2.67%). Significant inverse correlation was observed between LV GLPSS and IS (<em>p</em> <!-->=<!--> <!-->0.03, <em>r</em> <!-->=<!--> <!-->0.39) with the cut-off point for GLPSS, which defined large myocardial infarction size (⩾30% of LV mass), was −11.5% with 93% sensitivity and 67% specificity (AUC<!--> <!-->=<!--> <!-->0.8). Also LV GLPSS proportionally correlated with EF (<em>p</em> <!-->=<!--> <!-->0.01, <em>r</em> <!-->=<!--> <!-->0.35) and inversely correlated with WMSI (<em>p</em> <!-->=<!--> <!-->0.04, <em>r</em> <!-->=<!--> <!-->0.5). WMSI showed the most significant correlation to IS (<em>p</em> <!-->=<!--> <!-->0.0, <em>r</em> <!-->=<!--> <!-->0.64). Significant correlation was observed between IS and EF (<em>p</em> <!-->=<!--> <!-->0.04, <em>r</em> <!-->=<!--> <!-->0.37). No significant correlation was found neither between ESVI and IS (<em>p</em> <!-->=<!--> <!-->0.4, <em>r</em> <!-->=<!--> <!-->0.2) nor GLPSS (<em>p</em> <!-->=<!--> <!-->0.08, <em>r</em> <!-->=<!--> <!-->0.33).</p></div><div><h3>Conclusions</h3><p>Assessment of IS by echocardiography after PCI in patients with STEMI was superior with GLS and WMSI when compared with LVEF and ESVI. Since global strain is an inexpensive test, these data may be of health economic interest.</p></div>\",\"PeriodicalId\":31233,\"journal\":{\"name\":\"Egyptian Journal of Critical Care Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.3000,\"publicationDate\":\"2015-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.ejccm.2015.10.002\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Egyptian Journal of Critical Care Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2090730315000158\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Egyptian Journal of Critical Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2090730315000158","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
引用次数: 5
摘要
目的:通过斑点跟踪超声心动图(STE)评估STEMI患者经皮冠状动脉介入治疗(PCI)后24小时内的整体纵向峰值收缩应变(GLPSS)及其与左室梗死大小和射血分数的相关性。方法与结果共30例STEMI患者，平均年龄58±8岁，男性25例。所有患者均行1次PCI。常规二维超声心动图评估左室射血分数(LVEF)、壁运动评分指数(WMSI)、收缩期末期容积指数(ESVI)，第1次PCI术后24 h内行STE评估左室GLPSS。出院前通过心肌灌注显像估计梗死面积。所有STEMI患者GLPSS均较低(平均:−10.57±2.67%)。在LV GLPSS和IS之间观察到显著的负相关(p = 0.03, r = 0.39)， GLPSS的截止点为- 11.5%，定义了大心肌梗死大小(LV质量的小于或等于30%)，灵敏度为93%，特异性为67% (AUC = 0.8)。LV GLPSS与EF成比例相关(p = 0.01, r = 0.35)，与WMSI呈负相关(p = 0.04, r = 0.5)。WMSI与IS相关性最显著(p = 0.0, r = 0.64)。IS与EF有显著相关(p = 0.04, r = 0.37)。ESVI与IS (p = 0.4, r = 0.2)、GLPSS (p = 0.08, r = 0.33)均无显著相关性。结论与LVEF和ESVI相比，GLS和WMSI对STEMI患者PCI后超声心动图IS的评估优于LVEF和ESVI。由于全球菌株是一种廉价的测试，这些数据可能具有卫生经济利益。
Longitudinal strain in patients with STEMI using speckle tracking echocardiography. Correlation with peak infarction mass and ejection fraction
Aim
Our objective was to assess the global longitudinal peak systolic strain (GLPSS) by speckle tracking echocardiography (STE) in patients with STEMI in the first 24 h after primary percutaneous coronary intervention (PCI) and its correlation with LV infarction size and ejection fraction.
Methods and results
A total of 30 patients with STEMI (mean age: 58 ± 8 years, 25 men) were studied. All patients underwent 1ry PCI. Conventional 2D echocardiography was performed to assess left ventricular ejection fraction (LVEF), wall motion score index (WMSI), and end systolic volume index (ESVI), while STE was performed within 24 h of 1ry PCI to assess LV GLPSS. Infarction size was estimated by myocardial perfusion imaging before hospital discharges. All patients with STEMI had low LV GLPSS (mean: −10.57 ± 2.67%). Significant inverse correlation was observed between LV GLPSS and IS (p = 0.03, r = 0.39) with the cut-off point for GLPSS, which defined large myocardial infarction size (⩾30% of LV mass), was −11.5% with 93% sensitivity and 67% specificity (AUC = 0.8). Also LV GLPSS proportionally correlated with EF (p = 0.01, r = 0.35) and inversely correlated with WMSI (p = 0.04, r = 0.5). WMSI showed the most significant correlation to IS (p = 0.0, r = 0.64). Significant correlation was observed between IS and EF (p = 0.04, r = 0.37). No significant correlation was found neither between ESVI and IS (p = 0.4, r = 0.2) nor GLPSS (p = 0.08, r = 0.33).
Conclusions
Assessment of IS by echocardiography after PCI in patients with STEMI was superior with GLS and WMSI when compared with LVEF and ESVI. Since global strain is an inexpensive test, these data may be of health economic interest.
期刊介绍：
The Egyptian Journal of Critical Care Medicine is the official Journal of the Egyptian College of Critical Care Physicians, the most authoritative organization of Egyptian physicians involved in the multi-professional field of critical care medicine. The journal is intended to provide a peer-reviewed source for multidisciplinary coverage of general acute and intensive care medicine and its various subcategories including cardiac, pulmonary, neuro, renal as well as post-operative care. The journal is proud to have an international multi-professional editorial board in the broad field of critical care that will assist in publishing promising research and breakthrough reports that lead to better patients care in life threatening conditions, and bring the reader a quick access to the latest diagnostic and therapeutic approaches in monitoring and management of critically ill patients.
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