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首页> 外文期刊>Journal of Thoracic Disease >Prognostic relevance and clinical features of papillary muscle infarction with mitral regurgitation in patients with ST segment elevation myocardial infarction
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Prognostic relevance and clinical features of papillary muscle infarction with mitral regurgitation in patients with ST segment elevation myocardial infarction

机译：乳头状肌肉梗死与ST段升高患者乳头肌肉梗死的预后相关性及临床特征

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Background: Papillary muscle infarction (PapMI) combined with mitral regurgitation (MR) is a severe complication of ST-segment elevation myocardial infarction (STEMI). The features detected by cardiac magnetic resonance (CMR) imaging in PapMI have not been characterized. The aim of the present study was to assess the incidence, determinants, and the prognostic significance of PapMI with MR at 1-year follow-up in a study of patients with STEMI after primary percutaneous coronary intervention (pPCI). Methods: We enrolled 209 patients with STEMI reperfused by pPCI (12 hours after symptom onset) at 2 centers. CMR and echocardiography were performed within 1 week after infarction using a standardized protocol. According to the results of CMR and echocardiography, patients were divided into PapMI with MR, PapMI (PapMI without MR), and non-PapMI groups. The primary clinical endpoint of the study was the occurrence of major adverse cardiovascular events (MACE). Results: PapMI with MR was found in 27 patients (13%). The existence of PapMI with MR was associated with age (P0.001), impaired left ventricular ejection fraction (LVEF) (P=0.005), higher SYNTAX score (P=0.002), concentration of troponin I (P0.001), longer time to reperfusion (P0.001), more diabetics (P0.001), and microvascular occlusion (MVO) (P0.001). Binary logistic regression with stepwise backward selection analysis showed that advanced age, MVO, and impaired LVEF were independent risk factors for PapMI with MR. Patients in the PapMI with MR group had significantly more MACE compared with the PapMI and non-PapMI groups [PapMI with MR, 23 (85.2%) vs. PapMI, 21 (55.3%) vs. non-PapMI, 29 (20.1%)] at 1-year follow-up (P0.001). However, there were no pronounced differences in mortality rates among the 3 groups (P=0.071). Conclusions: The presence of PapMI with MR in patients with STEMI is associated with advanced age, MVO, and impaired LVEF, which can increase the rates of MACE.
机译：背景：乳头状肌肉梗死（Papmi）与二尖瓣流反流（MR）相结合，是ST段升高心肌梗死（Stemi）的严重并发症。通过PAPMI中的心脏磁共振（CMR）成像检测到的特征尚未表征。本研究的目的是评估PAPMI与1年后的乳膏的预后意义，在初生经皮冠状动脉介入（PPCI）后的患者的研究中。方法：在2个中心，我们注册了由PPCI（症状后12小时后的STEMI患者患者。使用标准化方案在梗死后1周内进行CMR和超声心动图。根据CMR和超声心动图的结果，患者与MR，Papmi（乳纸没有MR）和非PAPMI群体分为PAPMI。该研究的主要临床终点是主要不良心血管事件（MACE）的发生。结果：27名患者中发现MR的PAPMI（13％）。具有MR的PAPMI的存在与年龄（P <0.001）相关，左心室喷射部分受损（P = 0.005），较高的语法得分（P = 0.002），浓度肌钙蛋白I（P <0.001）浓度再灌注的时间（P <0.001），更多的糖尿病患者（P <0.001）和微血管闭塞（MVO）（P <0.001）。与逐步反向选择分析的二进制逻辑回归显示，高级年龄，MVO和受损的LVEF与MR先生的PAPMI是独立的危险因素。与PAPMI和非PAPMI群体相比，MAPMI的患者与MR组的术术均明显更多的术术（PAPMI与MR，23（85.2％）与PAPMI，21（55.3％）与非PAPMI，29（20.1％） ]在1年的随访时（P <0.001）。然而，3组中没有明显的死亡率差异（P = 0.071）。结论：STEMI患者MR的PAPMI存在与晚期，MVO和LVERED患者有关，可以提高术士的速度。

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