靶血管为前降支的急性ST段抬高型心肌梗死后HEpEF患者左心室整体纵向应变研究

Left ventricular global longitudinal strain in HFpEF patients after STEMI with left antrior descending artery occlusion

目的:研究靶血管为前降支(LAD)的急性ST段抬高型心肌梗死(STEMI)后射血分数保留的心力衰竭(HFpEF)患者的左心室整体纵向应变(GLS)与分节段纵向应变之间的关系。方法:选取山东第一医科大学附属中心医院2019年至2022年接受经皮冠状动脉介入治疗(PCI)的21例急性STEMI,且靶血管为LAD的HFpEF患者(超声心动图显示左室射血分数≥50%),设为STEMI组。对照组为21名同期接受心脏磁共振(CMR)检查的健康人群。比较2组间CMR特征、左心室GLS与分节段纵向应变之间的相关性。结果:与对照组相比,STEMI组患者各节段纵向应变均增加,2组间比较差异有统计学意义(P<0.05);STEMI组心尖部纵向应变与GLS关系最为密切(β=0.498,t=7.673,P<0.01)。结论:靶血管为LAD的急性STEMI后HFpEF患者心尖部纵向应变的改变可能与左心室整体GLS变化关系最为密切,应用CMR评估心尖部纵向应变可为评估心功能及疾病进展提供帮助。

Objective:To investigate the relationship between global longitudinal strain(GLS)of the left ventricle and segmental longitudinal strain(SLS)in ST-segment elevation myocardial infarction(STEMI)patients with preserved ejection fraction and left anterior descending artery occlusion.Methods:A total of 21 patients with acute STEMI undergoing primary percutaneous coronary intervention(PCI)received cardiac magnetic resonance(CMR)imaging at the Central Hospital of Shandong First Medical University from 2019 to 2022,and all had preserved left ventricular ejection fraction(LVEF≥50%)at echocardiography.In addition,21 normal subjects who underwent CMR examination during the same period served a control group.CMR characteristics and correlation between left ventricular GLS and SLS were compared between the two groups.Results:Compared with control group,SLS became significantly abnormal for all segments in patients with STEMI(P<0.05).Apical longitudinal strain was most closely related to the GLS in STEMI group(β=0.399,t=7.673,P<0.01).Conclusion:In STEMI patients with heart failure with preserved LVEF caused by LAD occlusion,the change of apical longitudinal strain is closely related to left ventricular GLS alterations.The finding suggests that assessment of apical longitudinal strain may be helpful for evaluating the treatment effect and disease progression.