[1]张宇杰,王迪,叶添宝,等.前壁心梗患者微循环功能障碍的影响因素及预测模型的建立 [J].介入放射学杂志,2024,33(11):1181-1185.
ZHANG Yujie,WANG Di,YE Tianbao,et al.The influencing factors of microcirculation dysfunction in patients with anterior wall acute myocardial infarction and the establishment of prediction model[J].journal interventional radiology,2024,33(11):1181-1185.
点击复制
前壁心梗患者微循环功能障碍的影响因素及预测模型的建立
()
《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]
- 卷:
-
33
- 期数:
-
2024年11
- 页码:
-
1181-1185
- 栏目:
-
心脏介入
- 出版日期:
-
2024-11-20
文章信息/Info
- Title:
-
The influencing factors of microcirculation dysfunction in patients with anterior wall acute myocardial infarction and the establishment of prediction model
- 作者:
-
张宇杰; 王迪; 叶添宝; 刘亮; 金贤; 沈成兴
-
- Author(s):
-
ZHANG Yujie; WANG Di; YE Tianbao; LIU Liang; JIN Xian; SHEN Chengxing.
-
Affiliated Shanghai Sixth People′s Hospital,School of Medicine,Shanghai JiaoTong University,Shanghai 200233,China
-
- 关键词:
-
【关键词】急性心肌梗死; 微循环功能障碍; caIMR
- 文献标志码:
-
A
- 摘要:
-
【摘要】目的探讨急性心梗后微循环障碍患者的影响因素并建立相关预测模型。方法纳入2017年1月至2020年9月在上海市第六人民医院行PCI治疗后使用caIMR评估微循环功能的前壁心梗患者130例,其中微循环阻力异常组52例,微循环阻力正常组78例。比较2组患者的临床资料。回归分析微循环障碍的影响因素。结果微循环阻力异常组的对比剂用量、发病-手术时间、Gensini总分和LAD Gensini评分分别为(121.92±31.37) mL、(10.51±5.12) min、(97.91±31.77)分和(69.36±13.15)分,均高于微循环阻力正常组的(109.03±28.2) mL、(4.94±2.94) min、(81.05±35.22)分和(54.45±23.48)分,差异均有统计学意义(均P<0.05)。建立了涵盖介入策略的预测模型,其准确性较常规模型更高,AUC为0.91比0.87,能较好预测心梗患者发生微循环障碍的风险。结论建立前壁心梗微循环障碍模型可以较好地区分心梗后微循环障碍的高危人群。
参考文献/References:
[1]Christensen DM,Strange JE,El-Chouli M,et al.Temporal trends in noncardiovascular morbidity and mortality following acute myocardial infarction[J].J Am Coll Cardiol,2023,82:971-981.
[2]Frantz S,Hundertmark MJ,Schulz-Menger J,et al.Left ventricular remodelling post-myocardial infarction:pathophysiology,imaging,and novel therapies[J].Eur Heart J,2022,43:2549-2561.
[3]赵亚男,崔佳宁,张兴华,等.ST段抬高型心肌梗死患者微血管阻塞与心脏磁共振测定的整体和局部心肌功能的关系[J].Chinese Med Sci J,2023,38:11-19.
[4]Konijnenberg LSF,Damman P,Duncker DJ,et al.Pathophysiology and diagnosis of coronary microvascular dysfunction in ST-elevation myocardial infarction[J].Cardiovasc Res,2020,116:787-805.
[5]Rush CJ,Berry C,Oldroyd KG,et al.Prevalence of coronary artery disease and coronary microvascular dysfunction in patients with heart failure with preserved ejection fraction[J].JAMA Cardiol,2021,6:1130-1143.
[6]Vancheri F,Longo G,Vancheri S,et al.Coronary microvascular dysfunction[J].J Clin Med,2020,9:2880.
[7]Tang N,Chen X,Li K,et al.Myocardial perfusion in ST-segment elevation myocardial infarction patients after percutaneous coronary intervention:influencing factors and intervention strategies[J].Cureus,2023,15:e42841.
[8]Montalto C,Kotronias RA,Marin F,et al.Pre-procedural ATI score(age-thrombus burden-index of microcirculatory resistance)predicts long-term clinical outcomes in patients with ST elevation myocardial infarction treated with primary percutaneous coronary intervention[J].Int J Cardiol,2021,339:1-6.
[9]Rampidis GP,Benetos G,Benz DC,et al.A guide for Gensini score calculation[J].Atherosclerosis,2019,287:181-183.
[10]李晓涛,黄超联,陈晓杰,等.Gensini评分在经完全血运重建急性ST段抬高型心肌梗死患者预后中的预测价值[J].中国心血管杂志,2023,28:411-416.
[11]Aldujeli A,Haq A,Tsai TY,et al.The impact of primary percutaneous coronary intervention strategies during ST-elevation myocardial infarction on the prevalence of coronary microvascular dysfunction[J].Sci Rep,2023,13:20094.
[12]Park H,Ahn JM,Kang DY,et al.Optimal stenting technique for complex coronary lesions:intracoronary imaging-guided pre-dilation,stent sizing,and post-dilation[J].JACC Cardiovasc Interv,2020,13:1403-1413.
[13]段洋,苗浩,裴思雨,等.caFFR及caIMR对急性心肌梗死患者药物球囊治疗预后的评估价值[J].山东医药,2022,62:81-83.
[14]尹达,朱皓,周旭晨,等.血栓抽吸联合冠状动脉内注射替罗非班对心肌再灌注的影响[J].介入放射学杂志,2011,20:522-525.
[15]Wang Y,Yao M,Liu H,et al.Correlation between balloon release pressure and no-reflow in patients with acute myocardial infarction undergoing direct percutaneous coronary intervention[J].Chin Med J (Engl),2014,127:1008-1011.
[16]Li X,Sun S,Luo D,et al.Microvascular and prognostic effect in lesions with different stent expansion during primary PCI for STEMI:Insights from coronary physiology and intravascular ultrasound[J].Front Cardiovasc Med,2022,9:816387.
[17]Saad M,Bavineni M,Uretsky BF,et al.Improved stent expansion with prolonged compared with short balloon inflation:a meta-analysis[J].Catheter Cardiovasc Interv,2018,92:873-880.
[18]Skowronski J,Wolny R,Jastrzebski J,et al.Impact of the balloon inflation time and pattern on the coronary stent expansion[J].J Interv Cardiol,2019,2019:6945372.
备注/Memo
- 备注/Memo:
-
(收稿日期:2024-03-28)
(本文编辑:新宇)
更新日期/Last Update:
2024-11-20