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在ST段升高冠状动脉干预后微血管阻塞的风险因素分析,心肌梗塞

Jiali Wang¹, Tianyu Geng², Xiaole Li²

¹Department of Radiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province 221002, PR China; School of Medical Imaging, Xuzhou Medical University, Xuzhou, Jiangsu Province 221002, PR China.

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概括

重灌治疗的延迟,特别是症状发作到线路时间超过300分钟,增加了ST升高心肌梗塞 (STEMI) 经皮冠状动脉干预 (PCI) 后微血管阻塞 (MVO) 的风险. 较短的缺血时间对于更好的结果至关重要.

科学领域:

心脏病学心脏病学
干预心脏病学干预心脏病学
心血管成像 - 心血管成像

背景情况:

微血管阻塞 (MVO) 是ST升高心肌梗塞 (STEMI) 的皮肤通冠状动脉干预 (PCI) 后的一种并发症.
识别MVO的风险因素对于改善PCI后的结果至关重要.

研究的目的:

在STEMI患者中研究PCI后与微血管阻塞 (MVO) 相关的风险因素.
为了确定治疗延迟对MVO发生的影响.

主要方法:

在一周内对165名接受紧急PCI和心磁共振 (CMR) 的STEMI患者进行了回顾性分析.
缺血时间的比较 (症状开始到线 - S2W,第一次医疗接触到线 - FMC2W,门到线 - D2W) 与关键时间节点.
使用CMR (cine和晚期-gadolinium增强 - LGE) 评估左心室功能和心肌梗塞特征.
二元物流回归分析,以评估治疗延迟对MVO的影响.

主要成果:

在PCI后的STEMI患者中,53.9%存在微血管阻塞 (MVO).
较长的FMC2W和S2W时间与MVO有显著的关联.
患有MVO的患者表现出更大的心肌梗塞大小 (IS) 和左下心室喷射率 (LVEF).
超过300分钟的症状发作到电线 (S2W) 时间被确定为MVO的独立预测因素 (OR=2.756,P=0.039).

结论:

缩短心肌缺血总时间对于预防或减少PCI后的MVO至关重要.
增加早期再输血治疗的速度可以减轻STEMI患者的MVO风险.

关键词:

心脏磁共振成像心脏磁共振成像缺血时间缺血时间微血管阻塞微血管阻塞通过皮肤进行冠状动脉干预.ST段升高心肌梗塞的心脏病发作

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