3D-STI在急性前壁心肌梗死评估中的应用价值

Value of 3D-STI in evaluation of acute anterior myocardial infarction

目的:分析3D-STI测量左心室径向应变(RS)、纵向应变(LS)在评价急性前壁心肌梗死左心功能及再灌注中的应用价值。方法:选取2016年1月~2017年4月间如皋市人民医院收治的100例急性前壁心肌梗死患者作为观察组,并同期选择100例健康体检者作为对照组;采用3D-STI技术检查患者RS、LS;以随访结果作为金标准,分析RS、LS在评价急性前壁心肌梗死左心功能及再灌注中的应用价值。结果:观察组3D-STI测量LS及RS的绝对值均高于对照组,且差异有统计学意义(P<0.05);观察组LVEF、LAD水平均低于对照组(P<0.05),且观察组LVESV及LVEDV均高于对照组;3D-STI检测RS指标预测左心功能良好共53例,LS预测良好56例;3D-STI检测RS指标预测心肌再灌注阳性共48例,LS预测阳性49例;3D-STI检测LS、RS预测左心功能及心肌再灌注的灵敏度及特异度均高于85%,且ROC曲线下面积均>0.85。结论:3D-STI测量左心室LS、RS可有效评价并预测急性前壁心肌梗死左心功能及再灌注,其灵敏度及特异度均较高,具有较高的临床应用价值。

Objective:To assess the value of left ventricular radial strain(RS) and longitudinal strain(LS) measured by three-dimensional speckle tracking imaging(3 D-STI) in evaluating left ventricular function and reperfusion in patients with acute anterior myocardial infarction.Methods:One hundred patients with acute anterior myocardial infarction,admitted to and treated in Rugao People′s Hospital,were included From January 2016 to April 2017 in observational group,and another 100 healthy subjects undergoing health examination in the corresponding period were recruited as controls.3 D-STI technique was used to measure the RS and LS,and the follow-up results were used as gold standard to analyze the role of RS and LS in evaluating left ventricular function and reperfusion of acute anterior myocardial infarction.Results:The absolute values of LS and RS measured by 3 D-STI in the observational group were significantly higher than those in the control group(P<0.05).Left ventricular ejection fraction(LVEF) and left anterior descending artery(LAD) levels were significantly lower in the observation group than in the control group(P<0.05),yet left ventricular end-systolic volume(LVESV) and left ventricular end-diastolic volume(LVEDV) were higher in the observational group than in the control group.Good left ventricular function predicted by 3 D-STI was seen in 53 subjects,and good LS in 56.Positive reperfusion as RS and LS predicted by 3 D-STI was found in 48 and 49 cases,respectively.The sensitivity and specificity of 3 D-STI in predicting left ventricular function and myocardial reperfusion wereover 85%,and the area under ROC curve was greater than 0.85%.Conclusion:Measurement of left ventricular longitudinal strain and radial strain by 3 D-STI can effectively evaluate and predict left ventricular function and reperfusion in patients with acute anterior myocardial infarction,suggesting that this technique has clinical value due to its higher sensitivity and specificity.