Evaluation of myocardial mechanical changes in patients with acute myocardial infarction before and after percutaneous coronary intervention by speckle tracking technique
10.3760/cma.j.issn.1004‐4477.2019.05.007
- VernacularTitle:超声斑点追踪技术评价急性心肌梗死经皮冠状动脉介入术前后心肌力学改变
- Author:
Tinghua FENG
1
;
Ruihuan ZHAO
;
Chunsong KANG
;
Xiaoyan CHEN
;
Junwang MIAO
Author Information
1. 山西医学科学院山西医科大学附属大医院超声科
- Keywords:
Echocardiography;
Acute myocardial infarction;
Speckle tracking;
M yocardial mechanics
- From:
Chinese Journal of Ultrasonography
2019;28(5):401-406
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the changes of myocardial mechanics before and after percutaneous coronary intervention ( PCI ) in patients with acute myocardial infarction ( AM I ) by ultrasonic speckle tracking technique ,and investigate the recovery of left ventricular myocardium mechanics and the effects of common complications on the improvement of myocardial mechanics . Methods Sixty‐two patients with AM I were examined by echocardiography within 12 hours ,1 week and 3 months after PCI . According to the complications the patients were divided into simple AM I group ( 21 cases ) ,AM I with diabetes mellitus group ( 21 cases) ,and AM I with hypertension group ( 20 cases) . T hirty healthy volunteers were selected as control group . Conventional echocardiographic parameters and left ventricular strain parameters were evaluated in all subjects . Results ①Left ventricular end‐diastolic diameter ( LVEDD) ,left ventricular end‐systolic diameter ( LVESD) ,left ventricular end‐diastolic volume ( LVEDV ) ,and left ventricular end‐systolic volume ( LVESV ) in each AM I group before PCI were greater than the control group ( P ＜ 0 .05 ) ,left ventricular ejection fraction ( LVEF ) , global longitudinal and circumferential endocardial ( midcardial , epicardial) strain ,and left ventricular global radial strain were smaller than the control group ( P ＜0 .05) ;the global longitudinal and circumferential endocardial ( midcardial ,epicardial ) strain ,and left ventricular global radial strain in AM I with diabetes group were less than simple AM I group and AM I with hypertension group ( P ＜0 .05) ; the global longitudinal endocardial strain in AM I with hypertension group was less than simple AM I group ( P ＜0 .05) . ② The LVESV in the third month after PCI was less than that before and during 1 week after surgery ( P ＜ 0 .05 ) ,still greater than control group ( P ＜ 0 .05 ) . LVEF ,the left ventricular global longitudinal and circumferential endocardial( midcardial ,epicardial) strain , and left ventricular global radial strain were greater than those before and during 1 week after surgery ( P＜0 .05) ,still less than control group ( P＜0 .05) ; T here was no significant difference before PCI and during 1 week after PCI about routine and strain parameters ( P＞0 .05 ) . ③ T he degree of improvement of global longitudinal and circumferential endocardial strain in AM I with diabetes group were less than those in simple AM I group( P ＜0 .05) . T he degree of improvement of global longitudinal endocardial strain in AM I with hypertension group was less than that in simple AM I group ( P ＜0 .05) . Conclusions Patients with AMI have poor myocardial mechanics before PCI ,especially those with diabetes mellitus ; myocardial mechanics improves significantly 3 months after PCI ; diabetes mellitus or hypertension affectes the improvement of myocardial mechanics in patients with AM I after PCI .
