| 摘要: |
| 目的 探讨心肌造影超声心动图(MCE)结合实时三维超声心动图(RT-3DE)对老年急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后主要心血管不良事件(MACE)的预测价值。方法 回顾性选取2020年1月~2023年7月至广东医科大学附属阳江市人民医院接受PCI治疗的95例老年AMI患者,根据是否发生MACE分为MACE组(31例)和非MACE组(64例)。比较两组患者临床资料、MCE和RT-3DE参数,采用多因素logistic回归分析老年心肌梗死患者PCI术后发生MACE的预测因子；绘制受试者工作特征曲线(ROC)确定 预测指标截断值,曲线下面积(AUC)评价MCE、RT-3DE参数对PCI术后发生MACE的预测效能。结果 MACE组心肌血流量(A.β)值、左室射血分数(LVEF)及高峰射血率(PER)明显低于非MACE组,而左室收缩末期容积(LVESV)显著高于非MACE组,差异均有统计学意义(P＜0.05)。经logistic回归分析显示,A.β、LVEF、PER、LVESV为PCI术后发生MACE的预测因子(P＜0.05)。ROC曲线结果显示,A.β、LVEF、PER和LVESV预测PCI术后发生MACE的AUC分别为0.768、0.675、0.792、0.786,联合预测因子AUC为0.931,显著高于单独指标(Z＝5.470、3.028、5.963、5.315,P＝＜0.01、0.003、＜0.01、＜0.01),联合预测因子敏感度为90.32％,特异度为85.94％。结论 MCE与RT-3DE可用于评估老年AMI患者PCI术后心肌灌注情况和左心功能,二者联合可预测PCI术后MACE的发生。 |
| 关键词: 心肌造影超声心动图 实时三维超声心动图 心肌梗死 经皮冠状动脉介入术 主要心血管不良事件 预测 |
| DOI： |
| 投稿时间：2024-02-20修订日期：2024-04-19 |
| 基金项目: |
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| Predictive value of MCE combined with RT-3DE for MACE in elderly AMI patientsafter interventional therapy |
| luoli,fengzhijie,chengxiaoyan,jiangxiaojie |
| () |
| Abstract: |
| Objective To investigate the predictive value of myocardial contrast echocardiography (MCE) combined with real-time three-dimensional echocardiography (RT-3DE) for major adverse cardiovascular events (MACE) in elderly patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods A total of 95 elderly patients with AMI who underwent PCI in People"s Hospital of Yangjiang, Guangdong Medical University from January 2020 to December 2023 were reviewed. They were divided into MACE group (31 cases) and non-MACE group (64 cases) according to the presence or absence of MACE. Clinical data, MCE and RT-3DE parameters of the two groups were compared. Multivariate logistic regression analysis was conducted to identify the predictors for the occurrence of MACE in elderly patients with myocardial infarction after PCI. The performance of MCE and RT-3DE parameters in predicting the occurrence of MACE after PCI was evaluated using the receiver operating characteristic (ROC) curve. Results Myocardial blood flow (A.β) value, left ventricular ejection fraction (LVEF) and peak ejection rate (PER) in the MACE group were significantly lower than those in the non-MACE group, and left ventricular end systolic volume (LVESV) was significantly larger than that in the non-MACE group (P<0.05). Logistic regression analysis found that A.β, LVEF, PER and LVESV were predictive factors for MACE after PCI (P<0.05). ROC curve analysis results showed that the AUC values of A.β, LVEF, PER and LVESV for predicting MACE after PCI were 0.768, 0.675, 0.792 and 0.786. The AUC of joint prediction with the three was 0.931, significantly larger than that of each parameter (Z＝5.470、3.028、5.963、5.315,P＝<0.01、0.003、<0.01、<0.01). The sensitivity and specificity of joint prediction were 90.32% and 85.94%. Conclusion MCE and RT-3DE can be used to evaluate myocardial perfusion and left ventricular function in elderly patients with AMI after PCI. Combination of the two can be used to predict the occurrence of MACE after PCI. |
| Key words: Myocardial contrast echocardiography Real-time three-dimensional echocardiography Myocardial infarction Percutaneous coronary intervention Major adverse cardiovascular event Prediction |
