Myocardial contrast echocardiography in evaluating microcirculation perfusion and prognosis after PCI in acute myocardial infarction
Han Weiwei
Hu Qin
Zhou Feng
Wang Limei
Abstract：Objective To investigate the value of myocardial contrast echocardiography(MCE)in evaluating microcirculation perfusion and prognosis of patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 319 patients with acute ST-segment elevation myocardial infarction(STEMI)admitted to the Department of Cardiology and Chest Pain Center of Shijiazhuang People's Hospital from February 2021 to August 2023 were selected as the study subjects.All patients underwent echocardiography and MCE within 7 days after PCI.According to the MCE results,the patients were divided into coronary microcirculation disorder(CMD)group and non-CMD group.The clinical data and MCE parameters of the two groups were compared.Major adverse cardiac events(MACE)were followed up after PCI.Results CMD was detected in 60.50%(193/319)of patients with MCE.Troponin I(cTnI),N-terminal B-type natriuretic peptide precursors(NT-proBNP),wall movement score index(WMSI),and the proportion of patients with high Killip grade and regional wall motion abnormality(RWMA)were significantly higher in CMD group than in non-CMD group(P<0.05),while left ventricular ejection fraction(LVEF)and left ventricular global longitudinal strain(GLS)were significantly lower than those in non-CMD group(P<0.05).The incidence of MACE in CMD group was significantly higher than that in non-CMD group(P<0.05).Patients were followed for 12.0(1.0～26.5)months.After adjusting for GRACE risk score,peak cTnI,and peak NT-proBNP,CMD remained an independent predictor of MACE[Adjusted odds ratio(OR):2.457;95%confidence interval(CI):1.042～5.790;P=0.040],and patients with CMD had a higher risk of hospitalization for heart failure(adjusted OR:2.115;95%CI:1.372～3.260;P=0.031).Kaplan-Meier curve showed that compared with non-CMD patients,CMD patients had shorter median MACE free survival time and lower MACE free survival rate after PCI,with statistical significance(P=0.001).Conclusion MCE is an inexpensive,non-invasive,safe and effective tool for monitoring microcirculation perfusion and identifying CMD occurrence.CMD measured by MCE was also significantly associated with an increased risk of MACE in AMI patients after PCI.
Keywords：Myocardial contrast echocardiographyAcute myocardial infarctionCoronary microvascular dysfunctionMajor adverse cardiovascular event
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 327-332 )