| 摘要: |
| 目的 采用三维斑点追踪成像(3D-STI)评估轻链型心肌淀粉样变(AL-CA)患者左室心肌应变与预后的关系。方法 回顾性分析2020年1月至2022年1月在我院确诊的120例AL-CA患者的临床资料,根据终点事件结果分为生存组(n=82)和死亡组(n=38)。记录患者临床资料、常规超声心动图参数[左室舒张末期最大室壁厚度(MLVWT)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)和左室射血分数(LVEF)]和3D-STI参数[左心室扭转角度峰值(Ptw) 、左心室整体纵向应变(GLS) 、左心室整体圆周应变(GCS) 、左心室整体径向应变(GRS)]。采用COX比例风险模型分析3SE-STI参数与AL-CA患者预后的关系。ROC 评估3D-STI参数对AL-CA患者预后的预测价值。结果 生存组和死亡组性别、年龄、心率和血压等一般资料没有显著差异(P＞0.05)。生存组B型脑钠肽前体(NT-proBNP)、肌钙蛋白I(cTnI)和肌酐(CRE)水平均明显低于死亡组(P＜0.05)。生存组和死亡组患者LVESV、MLVWT和GCS无显著差异(P＞0.05)；生存组患者LVEF、LVEDV、Ptw、GLS和GRS值明显高于死亡组(P＜0.05)。Ptw、GLS、GRS联合检测的敏感度和特异度较高,GLS是患者全因死亡的独立预测因素。结论 3D-STI能够反映AL-CA患者左室心肌应变,其相关参数在预测患者预后中也有参考价值。 |
| 关键词: 三维斑点追踪成像 轻链型心肌淀粉样变 左室心肌应变 预后 COX比例风险模型 |
| DOI： |
| 投稿时间：2022-10-26修订日期：2022-12-12 |
| 基金项目: |
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| Evaluation of the relationship between left ventricular myocardial strain and prognosis in patients with light chain cardiac amyloidosis by 3D-STI |
| caoshanshan,yuqian,wangjiawang,hanjia |
| () |
| Abstract: |
| Objective To evaluate the relationship between left ventricular myocardial strain and prognosis in patients with light chain cardiac amyloidosis (AL-CA) by three-dimensional speckle tracking imaging (3D-STI). Methods A retrospective analysis was performed on the clinical data of 120 patients with AL-CA confirmed in the hospital between January 2020 and January 2022. According to the results of end-point events, they were divided into survival group (n=82) and death group (n=38). The clinical data, routine echocardiogram parameters [maximum end-diastolic wall thickness of the left ventricular (MLVWT), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF)] and 3D-STI parameters [left ventricular twist (Ptw), global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS)] were recorded. The relationship between 3D-STI parameters and prognosis of AL-CA patients was analyzed by COX proportional hazards model. The predictive value of 3D-STI parameters for prognosis was evaluated by ROC curves. Results There was no significant difference in general data (gender, age, heart rate, blood pressure) between survival group and death group (P>0.05). The levels of N-terminal pro brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI) and creatinine (CRE) in survival group were significantly lower than those in death group (P<0.05). There was no significant difference in LVESV, MLVWT or GCS between survival group and death group (P>0.05). LVEF, LVEDV, Ptw, GLS and GRS in survival group were significantly greater than those in death group (P<0.05). The sensitivity and specificity of Ptw combined with GLS and GRS were high. GLS was an independent predictor of all-cause mortality. Conclusion 3D-STI can reflect left ventricular myocardial strain in patients with AL-CA, and 3D-STI parameters also have reference value to predict prognosis. |
| Key words: Three-dimensional speckle tracking imaging Light chain cardiac amyloidosis Left ventricular myocardial strain Prognosis COX proportional hazard model |
