摘要
目的探讨左室肥厚对急性ST段抬高型心肌梗死(STEMI)急诊介入术后微循环功能及左室重塑的影响。方法纳入112例STEMI且行急诊介入治疗的患者,术后即刻及1年随访分别行心脏彩超及心肌声学造影(MCE),根据超声结果分为左室肥厚组(A组,39例)、非左室肥厚组(B组,73例)。计算两组左室收缩末容量(LVESV)、舒张末容量(LVEDV)、左室质量指数(LVmassi)、左室射血分数(LVEF)、室壁运动评分指数(WMSI)、及造影剂评分指数(CSI)。比较A、B两组上述指标的变化。结果①入院时、1年随访时A组LVEDV水平均高于B组(入院122.5±16.9 vs.99.0±10.9 ml,P=0.003);随访发现LVEDV:132.3±12.8 vs.106.2±2.03 ml,P<0.001;LVESV水平可得出同样的结论;1年随访时A、B两组组内比较LVEDV、LVESV均未观察到随时间显著变化(P>0.05)。②A、B两组入院以及1年随访CSI、WMSI水平均无显著差异:CSI(入院1.4±0.18 vs.1.2±0.23,P=0.065,随访1.23±0.16 vs.0.92±0.33,P=0.053),WMSI(入院2.3±0.28 vs.2.0±0.24,P=0.062,随访1.80±0.44 vs.1.78±0.28,P=0.88),但随时间推移A、B两组组内比较CSI、WMSI有所改善。③1年随访时A、B两组左室重塑率无显著差异(23%vs.28%,P=0.65)。结论左室肥厚不影响STEMI急诊介入术后左室重塑的发生,也不意味着梗死后微循环及心肌损伤面积更大,同样左室肥厚并不能限制对微循环以及心肌损伤的缓慢修复。
Objective To investigate the influence of left ventricular hypertrophy(LVH)on microcirculation function and left ventricular remodeling after emergency percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods STEMI patients undergone emergency PCI(n=112)were chosen and given color echocardiogram and myocardial contrast echocardiography(MCE)immediately after PCI and followed up for 1 y.All patients were divided,according to results of color echocardiogram and MCE,into LVH group(group A,n=39)and non-LVH group(group B,n=73).The left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),left ventricular mass index(LVmassi),left ventricular ejection fraction(LVEF),wall motion score index(WMSI)and contrast scoring index(CSI)were calculated in 2 groups,and changes of them were compared between group A and group B.Results①The level of LVEDV was higher in group A than that in group B at hospitalization time(122.5±16.9 ml vs.99.0±10.9 ml,P=0.003)and after 1-y follow-up(132.3±12.8 vs.106.2±2.03 ml,P<0.001).The level of LVESV showed the same changes.The levels of LVEDV and LVESV were not observed that they changed along with time in group A and group B during 1-y follow-up period(P>0.05).②The levels of CSI and WMSI had no significant difference between 2 groups at different time points(CSI:1.4±0.18 vs.1.2±0.23,P=0.065 at hospitalization time,1.23±0.16 vs.0.92±0.33,P=0.053 after 1-y follow-up;WMSI:2.3±0.28 vs.2.0±0.24,P=0.062 at hospitalization time,1.80±0.44 vs.1.78±0.28,P=0.88 after 1-y follow-up).As passage of time the levels of CSI and WMSI were improved in group A and group B.③The left ventricular remodeling rate had no significant difference between 2 groups(23%vs.28%,P=0.65)after 1-y follow-up.Conclusion LVH does not influence the incidence of left ventricular remodeling and areas of post-infarction microcirculation and myocardial injury in STEMI patients after emergency PCI.LVH as well cannot inhibit the slow repair of microcirculation function and myocardial injury.
作者
陈亚南
郭秋红
冯雁
秦雷
Chen Yanan;Guo Qiuhong;Feng Yan;Qin Lei(Department of Cardiology,Central Hospital of Kaifeng City,Henan Province,Kaifeng 475000,China;不详)
出处
《中国循证心血管医学杂志》
2020年第8期952-955,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
2019年河南省医学科技攻关计划(LHGJ20191173)。
关键词
左心室肥厚
急性ST段抬高型心肌梗死
微循环功能
左心室重塑
Left ventricular hypertrophy
Acute ST-segment elevation myocardial infarction
Microcirculation function
Left ventricular remodeling
