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首页> 外文期刊>Circulation journal >Echocardiographic predictors of remote outcome in patients with angiographically successful reflow after acute myocardial infarction.
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Echocardiographic predictors of remote outcome in patients with angiographically successful reflow after acute myocardial infarction.

机译：在急性心肌梗死后血管造影成功回流的患者中，超声心动图可预测远端结局。

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BACKGROUND: The angiographically no-reflow phenomenon after percutaneous coronary intervention (PCI) predicts poor left ventricular (LV) functional recovery and a high risk of cardiac events in patients with their first acute myocardial infarction (AMI). However, risk factors of long-term adverse outcome for patients with angiographically successful reflow (TIMI (Thrombolysis in Myocardial Infarction) flow grade 3) for the AMI remain unknown. METHODS AND RESULTS: Of 168 echocardiograms were performed before PCI and at discharge, 113 were suitable for analysis. Clinical, angiographic, and echocardiographic variables were submitted to statistical analysis to detect the risk factors of cardiac events. During the follow-up period of 46+/-20 months, 31 patients had cardiac events, though there were no cardiac deaths. The 2 most important risk factors for congestive heart failure (CHF) or total cardiac events were LV dilation (chi-square: 7.5 and 9.4; both p<0.01) and pseudonormal transmitral flow pattern (PN, chi-square: 4.9, p<0.05 and 6.7, p<0.01, respectively). However, only multivessel disease (chi-square: 9.4, p=0.05) became the predictor for revascularization after PCI. The incidence of CHF or total cardiac events in patients with PN and LV dilation at discharge determined by the Kaplan-Meier method were significantly higher than those with normal or abnormal relaxation transmitral flow pattern (log-rank: 41 and 27, both p<0.001) and no LV dilation (log-rank: 20 and 20, both p<0.001). CONCLUSION: Poor LV diastolic function and LV dilation at discharge are predictors of the cardiac events in patients in whom epicardial coronary flow was well-restored after PCI for the first AMI.
机译：背景：经皮冠状动脉介入治疗（PCI）后的血管造影无再流现象预示着首例急性心肌梗死（AMI）患者的左心室（LV）功能恢复不良和发生心脏病的高风险。然而，对于AMI而言，血管造影成功回流（TIMI（心肌梗死中的溶栓）血流等级为3）的患者长期不良结局的危险因素仍然未知。方法和结果：在PCI术前和出院时进行了168次超声心动图检查，其中113例适合进行分析。临床，血管造影和超声心动图变量已提交统计分析，以检测心脏事件的危险因素。在46 +/- 20个月的随访期间，有31例患者发生了心脏事件，尽管没有心脏死亡。充血性心力衰竭（CHF）或总心脏事件的2个最重要的危险因素是左心室扩张（卡方值：7.5和9.4;均p <0.01）和伪正常传递血流模式（PN，卡方值：4.9，p < 0.05和6.7，p <0.01）。然而，只有多支血管疾病（卡方：9.4，p = 0.05）成为PCI后血运重建的预测指标。通过Kaplan-Meier方法测定出院时PN和LV扩张的患者的CHF或总心脏事件的发生率显着高于正常或异常松弛传递血流模式的患者（log-rank：41和27，均p <0.001 ）且没有LV扩张（对数等级：20和20，均p <0.001）。结论：出院后左室舒张功能差和左室舒张功能低下是预后第一个AMI患者心外膜冠状动脉血流恢复良好的患者心脏事件的预测指标。

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