左心系统超声造影增强联合二维斑点追踪预测心梗患者PCI术后不良事件价值研究

Value of contrast-enhanced left ventricular ultrasound combined with two-dimensional speckle tracking in predicting adverse events after PCI in patients with myocardial infarction

目的探讨左心系统超声造影增强联合二维斑点追踪预测心梗患者PCI术后不良事件的价值。方法选择2023年7月-2024年4月本院心内科收治的PCI术后患者60例为研究对象。根据心肌灌注评分指数(myocardial perfusionscore index,MPSI)分组,MPSI≤1.5为对照组(35例),MPSI>1.5为观察组(25例)。比较两组术后1个月异常灌注心肌A×β及整体心肌纵向应变值,以及两组术后1个月经胸左心系统超声造影结果,分析左心系统超声造影、二维斑点追踪指标单独及联合预测心梗PCI术后不良事件的价值。结果观察组其异常灌注心肌A×β水平低于对照组(P<0.05),同时整体心肌纵向应变值低于对照组(P<0.05),观察组LVEF和WMSI均低于对照组(P<0.05),LVIDd、LAD和LAVmax均高于对照组(P<0.05),异常灌注心肌A×β、整体心肌纵向应变值、LVEF和WMSI单独预测心梗PCI术后MACE发生的敏感度和特异度均低于多者联合,且多者联合预测心梗PCI术后MACE发生的AUC面积大于异常灌注心肌A×β、整体心肌纵向应变值、LVEF和WMSI单独预测者。结论左心系统超声造影联合二维斑点追踪预测心梗患者PCI术后不良事件发生有理想价值,值得临床重视。

Objective To explore the value of contrast-enhanced left ventricular ultrasound combined with two-dimensional speckle tracking in predicting adverse events after PCI in patients with myocardial infarction.Methods 60 patients who underwent PCI were selected as the research object from July 2023 to April 2024 according to myocardial perfusion score index(MPSI),60 cases were divided into control group(35 cases)(MPSI≤1.5)and observation group(25 cases)(MPSI>1.5).To compare the abnormal myocardial perfusion A×βand the longitudinal strain of the whole myocardium in the two groups one month after operation,and to analyze the value of contrast-enhanced ultrasound of the left heart system and two-dimensional speckle tracking index in predicting the adverse events after PCI.Results The level of abnormal myocardial perfusion A×βin the observation group was lower than that in the control group(P<0.05),and the longitudinal strain of the whole myocardium was lower than that in the control group(P<0.05).LVEF and WMSI in the observation group were lower than those in the control group(P<0.05),while LVIDd,LAD and LAVmax were higher than those in the control group(P<0.05).The sensitivity and specificity of abnormal myocardial perfusion A×β,global myocardial longitudinal strain,LVEF and WMSI alone in predicting the occurrence of MACE after PCI are lower than those of multi-combination,and the AUC area of multi-combination in predicting the occurrence of MACE after PCI was larger than those of abnormal myocardial perfusion A×β,global myocardial longitudinal strain,LVEF and WMSI alone.Conclusion Contrast-enhanced left ventricular ultrasound combined with two-dimensional speckle tracking has ideal value in predicting the occurrence of adverse events after PCI in patients with myocardial infarction,which deserves clinical attention.