左心房容积指数对急性心肌梗死患者直接经皮冠状动脉介入治疗的预后评价

Prognostic value of left atrial volume index in patients with acute myocardial infarction after primary percutaneous coronary intervention

目的研究左心房容积指数与急性心肌梗死患者直接经皮冠状动脉介入(percutaneous coronaryintervention,PCI)治疗的预后关系。方法回顾性分析116例确诊为急性心肌梗死的患者的资料,记录其入院后一般情况及PCI治疗后3 d内和12个月后左心室射血分数(left ventricular ejection fraction,LVEF)、左心房容积(left atrial volume,LAV)、左心房容积指数(left atrial volume index,LAVI)等。根据LAVI变化分为两组:Ⅰ组为降低组,Ⅱ组为升高组,并对两组相关资料进行比较。结果两组术前基线资料比较,差异无统计学意义(P>0.05)。Ⅰ组LVEF、LAV、LAVI的基础值和12个月后的随访值均比Ⅱ组低,差异有统计学意义(P<0.05)。Ⅰ组12个月后LAV、LAVI较基础值降低,LVEF值升高,差异均有统计学意义(P<0.05)。而Ⅱ组12个月后LAV、LAVI较基础值升高,差异有统计学意义(P<0.05);LVEF与基础值比较,差异无统计学意义(P>0.05)。Ⅱ组心房颤动发生率、因心力衰竭再住院率明显高于Ⅰ组,差异有统计学意义[14.8%(9/61)vs.1.8%(1/55),P<0.05;16.4%(10/61)vs.1.8%(1/55),P<0.05]。结论急性心肌梗死患者在直接PCI治疗后,LAVI升高预示随后发生不良后果。

Objectives To study the prognostic value of left atrial volume index（LAVI） in patients with acute myocardial infarction （AMI） undergoing primary percutaneous coronary intervention （PCI）. Methods Retrospective analysis on 116 cases diagnosed as AMI was carried out. Admission information, left ventricular ejection fraction （LVEF）, left atrial volume （LAV） and LAVI within 3 days and 12 months after PCI were recorded. All patients were divided into two groups according to LAVI changes： group Ⅰ （LAVI reduced after PCI） and group Ⅱ （LAVI elevated after PCI）,and relative data of the two groups were compared. Results Baseline data of the two groups were not significantly different （P〉0.05）. LVEF, LAV, LAVI of group Ⅰ were lower than those of group Ⅱ before and 12 months after PCI, and the differences were statistically significant （P〈0.05）. LAV, LAVI of group Ⅰ reduced 12 months after PCI, but LVEF increased, the differences were statistically significant （P〈0.05）. However, LAV, LAVI of group Ⅱ elevated after 12 months, and the differences were statistically significant （P〈0.05） ; but the difference of LVEF was not statistically significant （P〉0.05）. Incidence of atrial fibrillation, heart failure hospitalization rates of group Ⅱwere significantly higher than those of group Ⅰ , the differences were statistically significant [ 14.8% （9/61） vs. 1.8% （1/55）, P〈 0.05; 16.4% （10/61） vs. 1.8% （1/55）, P〈0.051. Conclusions In patients with AMI after primary PCI, increase of LAVI can foreshadow the ensuing negative consequences.