Relationship of Ultrasonic Myocardial Work and Myocardial Perfusion Im-aging Parameters with Left Ventricular Remodeling in Coronary Heart Dis-ease and Their Combined Predictive Efficacy

BAO Chengming; RAN Hong; JIA Hui; CHEN Xiaoyuan; QIAN Xiaofeng; YU Fudi; CHANG Xin

doi:10.3969/j.issn.1002-3429.2024.09.011

Abstract：Objective To investigate the relationship between ultrasonic myocardial work(MW),myocardial perfu-sion imaging(MPI)parameters and left ventricular remodeling in coronary heart disease(CHD)and their combined predic-tive efficacy.Methods A total of 100 patients with CHD treated from September 2020 to September 2022 were selected and divided into remodeling group(n=23)and non-remodeling group(n=77)according to presence of left ventricular remode-ling at 6 months after follow-up.The clinical data,cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV)],ultrasonic MW parameters[global myocardial work index(GWI),global constructive work(GCW),global wasted myocardial work(GWW),global myocardial work efficiency(GWE)],and MPI parameters[phase histogram bandwidth(PHB),phase standard deviation(PSD),R-MPI score]of the two groups were compared.The relationship between the above parameters and left ventricular remodeling in CHD patients and their predictive efficacy were analyzed,as well as the effects of ultrasonic MW and MPI pa-rameters on the risk of left ventricular remodeling in CHD patients.Results LVEF was lower,while LVESV and LVEDV were higher in remodeling group than in non-modeling group;GWI,GCW and GWE in the remodeling group were lower than those in the non-remodeling group,while GWW,PHB,PSD and R-MPI scores were higher than those in the non-remodeling group(P＜0.01).GWI,GCW and GWE were positively correlated with LVEF and negatively correlated with LVESV and LVEDV;GWW,PHB,PSD and R-MPI scores were negatively correlated with LVEF and positively correlated with LVESV and LVEDV(P＜0.01).GWI,GCW,GWE,GWW,PHB,PSD and R-MPI scores had significant effects on the risk of left ventricular remodeling(P＜0.01).The area under the receiver operating characteristic(ROC)curve(AUC)of ultrasonic MW parameters GWI,GCW,GWE,GWW combined with MPI parameters PHB,PSD,R-MPI scores in predicting left ven-tricular remodeling in CHD patients was0.929(95%CI:0.859,0.970),the sensitivity was 82.61%,and the specificity was 90.91%,which were better than each index alone.Conclusion Ultrasonic MW and MPI parameters are closely related to the risk of left ventricular remodeling in patients with CHD,and both can be used as predictive indicators.The combined predictive efficacy is high,and can provide reliable guidance information for early prevention and treatment in clinical prac-tice.