Predictive value of ultrasound stratified strain imaging parameters combined with laboratory indices for adverse left ventricular remodeling after acute ST-segment elevation myocardial infarction
WANG Lei
WANG Han
ZHAO De-xia
LI Yang
Abstract：Objective To investigate the predictive value of ultrasound stratified strain imaging parameters combined with laboratory indices for left ventricular adverse remodeling(LVAR)after acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 106 patients with acute STEMI who underwent percutaneous coronary intervention(PCI)in the Daqing Oilfield General Hospital from January 2022 to January 2024 were selected and were categorized into the occurrence group(31 cases)and the non-occurrence group(75 cases)according to whether LVAR occurred in the imaging findings.The general data,laboratory indexes,conventional ultrasound indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic internal diameter(LVEDD),left ventricular end-systolic internal diameter(LVESD),left atrial volume(LAVI)],ultrasound stratified strain imaging indexes[left ventricular myocardial global longitudinal strain(GLS),left ventricular global systolic circumferential strain(GCS)and peak strain dispersion(PSD)]were compared between the two groups.Logistic regression models were used to analyze the risk factors for the occurrence of LVAR,and the predictive value of ultrasound stratified strain imaging for LVAR in patients with acute STEMI was analyzed using the subject's work characteristics(ROC)curve.Results The percentage of patients with Killip classification≥grade 2 was higher in the occurrence group than in the non-occurrence group(P<0.05).The baseline cardiac troponin I(cTn-I),creatine kinase isoenzyme(CK-MB),myoglobin level,and plasma N-terminal B-type natriuretic peptide precursor(NT-proBNP)level were higher in the occurrence group than in the non-occurrence group(P<0.05).Both the GLS and PSD in the occurrence group were higher than those in the non-occurrence group(P<0.05).Multifactorial Logistic regression model showed that the baseline cTn-I,intra-GLS at 1 week postoperatively and postoperative PSD at 1 week postoperatively were the independent risk factors for the occurrence of LVAR(P<0.05).ROC curve analysis showed that the AUC(0.95CI)of baseline cTn-I,1-week postoperative GLS and PSD for predicting LVAR after acute STEMI alone and in combination were 0.794(0.704-0.866),0.832(0.747-0.898),0.831(0.746-0.897)and 0.948(0.887-0.982),and the efficacy of the three combined predictions was higher than that of each individual prediction(P<0.05).Conclusion The application of ultrasound stratified strain imaging at 1 week postoperatively would help to predict LVAR after acute STEMI,and the combination of the baseline laboratory index cTn-I with intraoperative GLS and PSD at 1 week postoperatively is an important reference for the prediction of LVAR.
Keywords：Acute ST-segment elevation myocardial infarctionUltrasound stratified strain imagingAdverse left ventricular remodeling
Publication Date：2025-01-09
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 40-46 )