Influence of Thrombolysis Therapy Before PCI on Long-Term Left Ventricular Global and Regional Function in ST Elevation Myocardial Infarction Patients by Cardiac Magnetic Resonance
10.3969/j.issn.1005-5185.2025.10.012
- VernacularTitle:心脏磁共振评估PCI前溶栓对急性ST段抬高型心肌梗死远期左心室整体和局部功能的影响
- Author:
Hao GONG
1
;
Yi XU
;
Yunfei WANG
;
Jiani YIN
;
Xiaomei ZHU
;
Chen LI
;
Chunjian LI
Author Information
1. 南京医科大学第一附属医院放射科,江苏 南京 210029
- Publication Type:Journal Article
- Keywords:
ST elevation myocardial infarction;
Magnetic resonance imaging;
Percutaneous coronary intervention;
Thrombolytic therapy;
Ventricular function,left
- From:
Chinese Journal of Medical Imaging
2025;33(10):1097-1103,1112
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the influence of thrombolysis therapy before percutaneous coronary intervention(PCI)on long-term left ventricular global and regional function in ST segment elevation myocardial infarction(STEMI)patients by cardiac magnetic resonance(CMR).Materials and Methods A retrospective analysis was conducted on 67 STEMI patients who were enrolled in a prospective study from November 2021 to August 2022 in the First Affiliated Hospital with Nanjing Medical University,the First People's Hospital of Lianyungang,the Affiliated Hospital of Jiangnan University,Changzhou No.2 People's Hospital and Huai'an Second People's Hospital and underwent CMR examination one year later.STEMI patients were divided into thrombolysis group and non-thrombolysis group according to whether a single half-dose of 5 mg recombinant staphylokinase(r-SAK)was given within two hours before the first medical contact and PCI.Based on CMR cine images,the traditional left ventricular function,global and segmental functional parameters were measured,and the differences between the two groups were compared.According to the degree of late gadolinium enhancement involvement,myocardial segments were divided into the following four types:transmural infarcted segments,non-transmural infarcted segments,locally infarcted segments,and non-infarcted segments.The parameters of the two groups were compared across these different segments.Results At the patient level,the cardiac index,left ventricular wall thickening and left ventricular wall motion in r-SAK thrombolysis group were higher than those in non-thrombolysis group(t/Z=-2.426,-4.307,-2.735,all P<0.05).At the segment level,compared with non-thrombolysis group,patients received r-SAK before primary PCI showed greater segmental radial strain in non-transmural infarcted segments(Z=-2.117,P=0.034);larger segmental wall motion in locally infarcted segments(Z=-2.235,P=0.025),and better segmental circumference strain in the non-infarcted segments(Z=-3.869,P<0.001).Conclusion The thrombolytic therapy before PCI in STEMI patients retain better long-term left ventricular global and regional function evaluating by CMR.
