Myocardial Contrast Echocardiography Combined with Strain Rate Imaging for Evaluation of the Readmission Risk within 1 Year after PCI for Acute Myocardial Infarction

WANG Junwei; DU Lijun; WANG Xu; ZENG Ling; SHEN Zhao; HOU Bo

doi:10.12102/j.issn.1672-1349.2025.01.015

Abstract：Objective: To explore the clinical value of myocardial contrast echocardiography (MCE) combined with strain rate imaging (SRI) in evaluating the risk of rehospitalization within one year after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI), aiming to provide reference for clinical treatment planning and prognosis improvement. Methods: A total of 185 AMI patients from December 2020 to December 2022 were selected as the study subjects. They were divided into a rehospitalization group and a non-rehospitalization group based on the rehospitalization rate within one year after PCI. Preoperative and postoperative one-year MCE quantitative parameters [slope of the curve (β), perfusion score index (PSI), peak intensity during the plateau phase (A), myocardial blood flow (A·β)], SRI quantitative parameters [peak longitudinal strain during systole (LS) of the infarcted myocardium, strain rate (LSR-s)], and conventional echocardiographic parameters [left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF)] were compared between the two groups. Pearson correlation analysis was used to evaluate the correlation between MCE and SRI quantitative parameters and conventional echocardiographic parameters. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of MCE and SRI quantitative parameters for the risk of rehospitalization within one year after PCI. Decision curve analysis (DCA) was performed to assess the clinical benefit of these parameters, and clinical impact curves (CIC) were used to evaluate the superiority of different models in predicting rehospitalization after PCI. Results: At one year post-surgery, the rehospitalization group had higher PSI, LS, and LSR-s of the infarcted myocardium, but lower A·β and A compared to the non-rehospitalization group (P < 0.05). The rehospitalization group also had lower LVEF and higher LVESD and LVEDD compared to the non-rehospitalization group (P < 0.05). PSI, A·β, A, β, LS, and LSR-s of the infarcted myocardium were correlated with LVEF (P < 0.05). The area under the curve (AUC) for predicting rehospitalization within one year after PCI using the combination of MCE and SRI quantitative parameters was 0.930, which was better than using either parameter alone. DCA showed that when the threshold was between 0.0 and 1.0, the combined model of MCE and SRI had better predictive performance than using only MCE or only SRI. Conclusion: MCE combined with SRI can be used for assessing the risk of rehospitalization within one year after PCI in AMI patients. Clinically, it can be used for early prediction of rehospitalization risk, enabling targeted subsequent treatment and reducing the rehospitalization rate.