冠状动脉微循环阻力对STEMI介入术后左心室重塑的影响

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Abstract Objective To investigate the effect of coronary index of microcirculatory resistance (IMR) on left ventricular remodeling after ST-segment elevation myocardial infarction (STEMI) intervention. Methods A total of 83 STEMI patients admitted to Suzhou Jiulong Hospital, Shanghai Jiao Tong University School of Medicine from July 2018 to December 2019 were enrolled and all underwent direct percutaneous coronary stent implantation (PCI) after admission. IMR after PCI treatment was measured intraoperatively, and the patients were divided into high IMR group (38 cases, IMR≥25 U) and normal IMR group (45 cases, IMR<25 U). All patients were routinely followed up with color ultrasound six months after surgery, and the changes of heart function and the condition of left ventricular remodeling were compared between the two groups, and the relationship between IMR and left ventricular remodeling and its predictive value were evaluated. Results Compared with the hospital, six months after surgery, LVEF was decreased and LVEDV was increased in the high IMR group, and the differences were statistically significant (all P ＜ 0.05). Six months after surgery, the left ventricular ejection fraction (LVEF) of the high IMR group was lower than that of the normal IMR group, and the left ventricular end-diastolic volume (LVEDV) and the incidence of left ventricular remodeling were higher than that of the normal IMR group, and the differences were statistically significant (all P ＜ 0.05). Pearson correlation analysis showed that IMR was negatively correlated with LVEF (r = -0.357) and positively correlated with LVEDV (r = 0.608) (all P ＜ 0.05). Multiple logistic regression analysis showed that IMR was an risk factor for left ventricular remodeling after intervention in patients with STEMI (OR = 1.87, 95%CI: 1.07-3.25, P < 0.05). Receiver operating characteristic curve indicated that the area under curve of IMR predicting left ventricular remodeling six months after intervention in STEMI patients was 0.84 (95%CI: 0.76-0.93), the best diagnostic threshold was 32.64 U, and the sensitivity and specificity were 69% and 78%, respectively. Conclusion IMR affects cardiac function and left ventricular volume after STEMI intervention, and is an risk factor for left ventricular remodeling in STEMI.

Key words： ST-segment elevation myocardial infarction Index of microcirculatory resistance Intervention Cardiac function Left ventricular remodeling

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	CHEN Ze LI Jiawei▲

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CHEN Ze LI Jiawei▲. Effect of coronary microcirculation resistance on left ventricular remodeling after STEMI intervention[J]. 中国医药导报, 2021, 18(11): 58-61.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I11/58

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