The Value of Angiography-derived Microcirculatory Resistance in Predicting Ventricular Remodeling in Patients With ST-segment Elevation Myocardial Infarction
10.3969/j.issn.1000-3614.2025.02.004
- VernacularTitle:冠状动脉造影衍生的微循环阻力指数对ST段抬高型心肌梗死患者心室重构的预测价值
- Author:
Guanyu LU
1
;
Lei ZHAO
;
Keyao HUI
;
Zhihui LU
;
Lanling WANG
;
Hai GAO
;
Xiaohai MA
Author Information
1. 首都医科大学附属北京安贞医院 介入诊疗科,北京 100029
- Publication Type:Journal Article
- Keywords:
angiography-derived microcirculatory resistance;
ST-segment elevation myocardial infarction;
coronary microcirculation;
ventricular remodeling
- From:
Chinese Circulation Journal
2025;40(2):138-144
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To explore the correlation between angiography-derived microcirculatory resistance(AMR)and microvascular obstruction(MVO)extent,and AMR's predictive value for ventricular remodeling in patients with ST-segment elevation myocardial infarction(STEMI)post-primary percutaneous coronary intervention(PCI).Methods:This retrospective study included STEMI patients who underwent PCI at Beijing Anzhen Hospital from April 2019 to January 2023.Patients underwent acute and follow-up cardiac magnetic resonance(CMR)examinations 3-7 days and 3 months post-PCI.Ventricular remodeling was defined as a 20%or more increase in left ventricular end-diastolic volume at follow-up.Patients were divided into ventricular remodeling and non-ventricular remodeling groups.Baseline clinical characteristics,AMR values and CMR indices of both groups were compared.Pearson's correlation coefficient was used to explore the correlation between AMR and MVO extent on CMR.Logistic regression and receiver operating characteristic curve analysis were employed to evaluate the predictive performance of AMR for ventricular remodeling.Results:A total of 168 STEMI patients([56.4±11.4]years,139[82.7%]males)were included,with 49(29.2%)in the ventricular remodeling group and 119(70.8%)in the non-ventricular remodeling group.AMR was positively correlated with MVO extent on CMR(r=0.42,P<0.01).Compared to the non-ventricular remodeling group,patients in the ventricular remodeling group exhibited a higher AMR value(3.00[2.56,3.52]mmHg?s/cm vs.2.48[2.20,2.74]mmHg?s/cm,1 mmHg=0.133 kPa,P<0.01).Multivariate logistic analysis showed that AMR was independently associated with ventricular remodeling post-PCI in STEMI patients.For every 0.2 mmHg·s/cm increase in AMR,the risk for ventricular remodeling increased 45.1%(adjusted OR=1.451,95%CI:1.228-1.714,P<0.01).Area under the curve of AMR for predicting ventricular remodeling was 0.769.Conclusions:AMR is positively correlated with MVO extent and is an independent predictor for ventricular remodeling in STEMI patients post-PCI.
