定量组织速度显像评价早期的延迟PCI治疗对急性心肌梗死患者心功能的影响

The influence of late reperfusion(12-48hours) PCI for acute myocardial infarction using Doppler tissue imaging on cardiac function

目的应用定量组织速度显像评价早期的延迟PCI再灌注治疗（STEMI发病12~24 h内）对急性心肌梗死收缩和舒张功能的影响。方法本研究共入选35例在发病12h-24h仍有进行性缺血性胸痛的急性ST段抬高性的心肌梗死患者,于PCI术前及术后3个月分别测定二尖瓣环收缩期、舒张早期和舒张晚期运动速度峰值Sa、Ea和Aa,并计算舒张早期运动速度峰值与舒张晚期运动速度峰值的比值Ea/Aa。结果 1二尖瓣环收缩期运动速度峰值：术后3个月比术前升高,差异有统计学意义（P〈0.05）;2二尖瓣环舒张早期运动速度峰值：术后3个月、与术前对比有明显升高,差异有统计学意义（P〈0.05）。3二尖瓣环舒张早期运动速度峰值/舒张晚期运动速度峰值比值（Ea/Aa）：术后3个月与术前对比有明显升高,差异有统计学意义（P〈0.05）。结论早期的延迟PCI再灌注治疗可以改善急性心肌梗死患者的左心室收缩和舒张功能;定量组织速度显像可以评价急性心肌梗死患者急诊PCI术后左心室收缩和舒张功能变化。

Objectives To evaluate the clinical value of quantitative tissue velocity imaging in detecting left ventricular systolic and diastolic function in patients with late reperfusion（12-48hours） PCI for ST-segment elevated myocardial infarctions. Methods The study group included 35 patients with acute myocardial infarction. Mitral annulus motion velocity during systole（Sa）, early diastole（Ea） and atrial contraction（Aa） by tissue velocity imaging were measured on the7 thday, the 3thmomth and the 6thmonth after late reperfusion（12hours-） using sirolimus-eluting stents, Ea/Aa was also detected. Results（1）Sa at the 3thmonth after PCI. was increased significantly compared with that before PCI（P 0.05）.（2）Ea at the 3thmonth after PCI. was also increased significantly compared with that before PCI（P 0.05）.（2）Ea at the 3th and the 6thmonth after PCI. was also increased significantly compared with that before PCI（P 0.05）.（3）Ea/Aa at the 3th month after PCI was increased significantly compared with that before PCI（P 0.05）. Conclusion Late reperfusion（12-48 hours） PCI for ST-segment elevated myocardial infarctions can improve left ventricular systolic and diastolic function.Quantitative tissue velocity imaging may be a useful tool to assess the left ventricular systolic and diastolic function.