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目的:应用定量组织速度成像技术(QTVI)检测经皮冠状动脉介入治疗(PCI)后的ST段抬高的急性心肌梗死(STEMI)患者左心室收缩功能的改变;评价QTVI指标对该类患者未来发生心力衰竭的预测价值。方法:选择行急诊PCI术治疗的冠状动脉单支病变的急性心肌梗死患者,术后一周测量患者的左心室射血分数(LVEF),LVEF<50%者排除,LVEF≥50%者入选。共38例。并设正常对照组30例。入选者继续测二尖瓣环室间隔侧和左室侧壁侧QTVI曲线上心室收缩期速度峰值(Sa),并计算左室平均收缩期速度峰值(mean Sa)。术后12个月随访,查LVEF。结果:PCI术12个月后有17位患者LEVF<50%,21位患者LEVF≥50%。入选的STEMI者术后7天的左室平均Sa波峰值低于正常对照组。术后12个月出现LVEF减低(<50%)的患者,其术后7天的左室平均Sa波峰值低于PCI术12个月后LVEF正常的患者(P<0.01)。结论:通过QTVI检测二尖瓣环的运动速度能够早期发现单支病变所致的急性心肌梗死患者在急诊PCI术后的左心室功能受损;PCI术后LVEF正常的STEMI患者,术后7天QTVI测得的左室平均Sa波峰值减低可能预示着将来发展为LVEF减低的左心室收缩功能不全。
Objective: To evaluate the changes of left ventricular systolic function in patients with ST-elevation acute myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) by quantitative tissue velocity imaging (QTVI). To evaluate the effect of QTVI on the future of these patients Predictors of heart failure. Methods: The patients with acute myocardial infarction with coronary artery disease undergoing emergency PCI were enrolled. Left ventricular ejection fraction (LVEF) was measured in one week after surgery. LVEF was less than 50% and LVEF≥50%. A total of 38 cases. And set the normal control group of 30 cases. Participants continued to measure the peak ventricular systolic velocity (Sa) of the QTVI curve in the mitral annular interventricular septum and the left ventricular lateral wall, and calculated the mean left ventricular systolic velocity (mean Sa). After 12 months of follow-up, check LVEF. Results: LEVF was <50% in 17 patients 12 months after PCI and 21% in 21 patients. The left ventricular average Sa wave peak of the selected STEMI patients 7 days after operation was lower than that of the normal control group. Patients with LVEF reduction (<50%) at 12 months postoperatively had a lower left ventricular Sa peak at 7 days than those at 12 months after PCI (P <0.01). Conclusion: The detection of mitral annular velocity by QTVI can early detect the left ventricular dysfunction after acute PCI in patients with acute myocardial infarction caused by single-vessel disease. In STEMI patients with normal LVEF after PCI, after 7 days QTVI measured left ventricular Sa peak reduction may predict the future development of LVEF decreased left ventricular systolic dysfunction.