Predictive value of Pcv-aCO 2 on left ventricular ejection fraction in myocardial infarction
10.3760/cma.j.issn.1671-0282.2023.05.018
- VernacularTitle:静动脉血二氧化碳分压差对心肌梗死射血分数的预测价值
- Author:
Chao YANG
1
;
Jie LIN
;
Chunjin LIN
;
Guojian XIANG
;
Linwei LIU
;
Tingting SHI
;
Yonghong ZHENG
Author Information
1. 福建医科大学省立临床医学院,福建省立医院重症医学四科,福州 350001
- Keywords:
Central venous-arterial blood carbon dioxide partial pressure difference;
Ejection fraction;
Acute myocardial infarction;
Lactate;
Central venous oxygen s
- From:
Chinese Journal of Emergency Medicine
2023;32(5):667-673
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between central venous-arterial blood carbon dioxide partial pressure difference (Pcv-aCO 2) and left ventricular ejection fraction(LVEF) in acute myocardial infarction. Methods:Clinical data of patients with acute myocardial infarction admitted to the Intensive Care Unit of Fujian Provincial Hospital from November 2019 to October 2021 were retrospectively analyzed. LVEF was measured by bedside echocardiogram. The patients were divided into the normal LVEF group (LVEF ≥ 52%) and decreased LVEF group (LVEF < 52%) according to LVEF. The differences in general information and hemodynamic parameters between the two groups were compared. The normality of the above data was tested by the Jarque-Bera test. Correlation analysis of hemodynamic indices with LVEF was performed. Binary logistic regression was used to analyze the risk factors associated with the decrease in LVEF. The feasibility of diagnosing LVEF decline with Pcv-aCO 2 was assessed using receiver operating characteristic (ROC) curve. Results:Seventy-two patients with acute myocardial infarction were included for analysis, including 25 patients in the normal LVEF group and 47 patients in the decreased LVEF group. Pcv-aCO 2 was significantly higher in the decreased LVEF group than that in the normal LVEF group [(7.13±1.19) mmHg vs. (5.41±1.23) mmHg, P<0.01]. There was a negative correlation between LVEF and Pcv-aCO 2 ( rs= -0.740, P<0.01). The area under the ROC curve for Pcv-aCO 2 was 0.849 (95% CI: 0.758-0.939, P<0.01). The binary logistic regression analysis showed that Pcv-aCO 2 was an independent risk factor for decreased LVEF ( OR=2.251, 95% CI: 1.326-3.820). Conclusions:To a certain extent, the increase of Pcv-aCO 2 can predict the decrease of LVEF in acute myocardial infarction.