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首页> 外文期刊>The American Journal of Cardiology >Comparison of Left Ventricular Function and Myocardial Infarct Size Determined by 2-Dimensional Speckle Tracking Echocardiography in Patients With and Without Chronic Obstructive Pulmonary Disease After ST-Segment Elevation Myocardial Infarction
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Comparison of Left Ventricular Function and Myocardial Infarct Size Determined by 2-Dimensional Speckle Tracking Echocardiography in Patients With and Without Chronic Obstructive Pulmonary Disease After ST-Segment Elevation Myocardial Infarction

机译：左心室功能和心肌梗塞尺寸的比较二维散斑跟踪超声心动图在ST段抬高后慢性阻塞性肺疾病患者中的二维斑点追踪超声心动图谱

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Patients with chronic obstructive pulmonary disease (COPD) have a high risk of mortality after acute ST-segment elevation myocardial infarction (STEMI). We compared STEMI patients with versus without COPD in terms of infarct size and left ventricular (LV) systolic function using advanced 2-dimensional speckle tracking echocardiography. Of 1,750 patients with STEMI (mean age 61 12 years, 76% male), 133 (7.6%) had COPD. With transthoracic echocardiography, left ventricular ejection fraction (LVEF) and wall motion score index were measured. Infarct size was assessed using biomarkers (creatine kinase and troponin T). LV global longitudinal strain (GLS), reflecting active LV myocardial deformation, was measured with 2-dimensional speckle tracking echocardiography to estimate LV systolic function and infarct size. STEMI patients with COPD were significantly older, more likely to be former smokers, and had worse renal function compared with patients without COPD. There were no differences in infarct size based on peak levels of creatine kinase (1315 [613 to 2181] vs 1477 [682 to 3047] U/l, p = 0.106) and troponin T (3.3 [1.4 to 7.3] vs 3.9 [1.5 to 7.8] RA p = 0.489). Left ventricular ejection fraction (46% vs 47%, p = 0.591) and wall motion score index (1.38 [1.25 to 1.66] vs 1.38 [1.19 to 1.69], p = 0.690) were comparable. In contrast, LV GLS was significantly more impaired in patients with COPD compared with patients without COPD (-13.9 +/- 3.0% vs 14.7 +/- 3.9%, p = 0.034). In conclusion, despite comparable myocardial infarct size and LV systolic function as assessed with biomarkers and conventional echocardiography, patients with COPD exhibit more impaired LV GLS on advanced echocardiography than patients without COPD, suggesting a greater functional impairment at an early stage after STEMI. (C) 2017 The Author(s). Published by Elsevier Inc.
机译：慢性阻塞性肺病（COPD）患者在急性ST段抬高心肌梗死（STEMI）后的死亡风险高。我们将Stemi患者与使用先进的二维散斑跟踪超声心动图造影的梗塞尺寸和左心室（LV）收缩功能进行了与梗死尺寸和左心室（LV）收缩功能进行了比较。 1,750名患有1,750名患者（平均年龄61岁12岁，76％男），133（7.6％）具有COPD。利用经晶心囊造影，测量左心室喷射分数（LVEF）和壁运动得分指数。使用生物标志物（肌酸激酶和肌钙蛋白T）评估梗塞大小。 LV全局纵向菌株（GLS），反映活性LV心肌变形，用二维散斑跟踪超声心动图测量，以估计LV收缩功能和梗塞尺寸。 STEMI患有COPD的患者显着老化，更有可能是前吸烟者，并且与没有COPD的患者相比，肾功能较差。基于肌酸激酶的峰值水平（1315 [613至2181] Vs1477 [682至3047] U / L，P = 0.106）和肌钙蛋白T（3.3 [1.4至7.3] Vs 3.9 [1.5]为7.8] ra p = 0.489）。左心室喷射级分（46％vs 47％，P = 0.591）和壁运动得分指数（1.38 [1.25至1.66] Vs 1.38 [1.19至1.69]，P = 0.690）是可比的。相比之下，与没有COPD的患者（-13.9 +/- 3.0％VS 14.7 +/- 3.9％，P = 0.034），LV GLS在COPD患者中显着损害。总之，尽管具有与生物标志物和常规超声心动图评估的心肌梗死大小和LV收缩功能，但COPD患者在高端超声心动图中表现出比没有COPD的患者在高端超声心动图上表现出更多的患者。 （c）2017年作者。 elsevier公司发布

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