不同时间的无创左室压力-应变环技术对冠心病多支病变患者预后的预测价值
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南京医科大学康达学院科研发展基金项目(KD2022KYJJZD013);


The predictive value of the non-invasive left ventricular pressure-strain loop technique at different times on the prognosis of patients with mul-tivessel coronary heart disease
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    摘要:

    目的:分析不同时间的无创左室压力-应变环(LV-PSL)技术对冠心病多支病变患者预后的预测价值。方法:将接受冠状动脉搭桥术治疗的108例冠心病多支病变患者作为研究对象,术前、术后1周均接受LV-PSL检查。术后随访3个月,根据患者术后不良心血管发生情况分为预后良好组(n=74)、预后不良组(n=34)。比较两组患者一般资料、术前和术后1周的左室整体纵向应变(GLS)、心肌做功指数,以Logistic回归分析心肌做功参数与冠心病多支病变患者预后的相关性;LV-PSL参数的预测效能采用受试者工作特征(ROC)曲线分析。结果:术后1周,冠心病多支病变患者GLS、整体无用功(GWW)水平均低于术前,整体做功指数(GWI)、整体有用功(GCW)、整体做功效率(GWE)均高于术前(P<0.05);预后不良组术后GWI、GCW、GWE水平均低于预后良好组,GWW水平高于预后良好组(P<0.05);Logistic回归显示,GWI、GWE、GWW是冠心病多支病患者预后影响因素(P<0.05);ROC曲线显示,GWI、GWW、GWE的曲线下面积(AUC)分别为0.628、0.695、0.827,以GWE的AUC最高,其敏感度和特异度分别为73.53%、78.38%(P<0.05)。结论:LV-PSL技术可用于冠心病多支病变患者预后评估,术后1周时的GWI、GWW、GWE对此类患者预后有较好的预测效能。

    Abstract:

    Objective:To analyze the predictive value of non-invasive left ventricular pressure-strain loop(LV-PSL)technology at different times on the prognosis of patients with multivessel coronary heart disease.Methods:All 108 patients with multi-vessel coro-nary artery disease were treated with coronary artery bypass grafting,and LV-PSL was examined before and 1 week after surgery.After 3 months of postoperative follow-up,the patients were divided into good prognosis group(n=74)and poor prognosis group(n=34)according to the incidence of postoperative major adverse cardiovascular events(MACE).The two groups were compared on general in-formation,left-ventricular global longitudinal strain(GLS)and myocardial work parameters.Logistic regression analysis was used for correlation analysis.The predictive efficacy of LV-PSL parameters was analyzed using the receiver operating characteristic(ROC)curve.Results:The levels of GLS and global waste work(GWW)in patients with multi-vessel coronary heart disease 1 week after sur-gery were lower than those before operation,and the overall work index(GWI),overall useful work(GCW)and overall work efficiency(GWE)were higher than those before surgery(P<0.05).Postoperative GWI,GCW and GWE in the poor prognosis group were lower than those in the good prognosis group,while GWW was higher than that in the good prognosis group(P<0.05).Logistic regression a-nalysis showed that GWI,GWE,and GWW were factors influencing the prognosis in patients with coronary heart disease and multivessel disease(P<0.05).The ROC curve showed that the areas under the curve(AUCs)of GWI,GWW and GWE were 0.628,0.695 and 0.827,showed that the AUC of GWE was the largest.Its sensitivity and specificity were 73.53%and 78.38%(P<0.05).Conclu-sion:The LV-PSL technique can be used for prognosis evaluation of patients with coronary heart disease and multivessel disease.GWI,GWW,and GWE at a week after surgery demonstrate relatively high predictive efficacy for the prognosis.

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陈允安;张洁;张鹏英;张曼;.不同时间的无创左室压力-应变环技术对冠心病多支病变患者预后的预测价值[J].川北医学院学报,2025,40(5):633-637.

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  • 在线发布日期: 2025-07-09
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