Predictive value of real-time 3D echocardiographic parameters for in-stent restenosis after percutaneous coronary intervention in patients with acute myocardial infarction

doi:10.3760/cma.j.cn441417-20240824-03002

Abstract

Abstract:

Objective　To assess the value of real-time 3D echocardiographic parameters in predicting in-stent restenosis after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction. Methods　This study was a retrospective analysis. The clinical data of 100 patients with acute myocardial infarction who underwent PCI in Hanzhong People's Hospital from July 2019 to January 2022 were collected. The patients were divided into a restenosis group (30 cases) and a non-restenosis group (70 cases) according to in-stent restenosis within 6 months after surgery. The left ventricular function and synchronization parameters were compared between the two groups. Lasso regression modeling was used to screen out the key characteristic variables of restenosis, and the clinical value of the variables was evaluated by the receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA). Independent sample t test and χ² test were used for statistical analysis. Results　The left ventricular end-diastolic volume (LVEDV) in the restenosis group was higher than that in the non-restenosis group [(142.07±28.62) ml vs. (113.83±32.55) ml], but the left ventricular ejection fraction (LVEF), peak ejection rate (PER)/end-diastolic volume (EDV), and peak filling rate (PFR)/EDV were all lower than those in the non-stenosis group [(46.77±4.26)% vs. (49.84±4.26)%, (1.89±0.62) L/s vs. (2.47±0.87) L/s, (1.36±0.45) L/s vs. (1.77±0.68) L/s], with statistically significant differences (t=4.335, -3.312, -3.794, and -3.598, all P<0.001). The characteristic variables of in-stent restenosis were screened by Lasso regression analysis, and 5 characteristic variables were obtained, including LVEDV, LVEF, Tmsv12-Dif/R-R, Tmsv12-SD/R-R, and Tmsv16-SD/R-R. The risk score of the restenosis group was lower than that of the non-restenosis group [(0.02±0.99) points vs. (1.54±1.07) points, t=6.653, P<0.001], and the area under the curve of the Lasso risk score was 0.866. Conclusions　In this study, we assessed left ventricular function and synchronization by real-time 3D echocardiography and LASSO regression in patients after PCI, screening key characteristic variables to predict restenosis risk.

Key words:

Acute myocardial infarction, Percutaneous coronary intervention, Real-time 3D echocardiography, In-stent restenosis, Prediction

摘要：

目的　本研究旨在评估实时三维超声心动图参数预测急性心肌梗死患者经皮冠状动脉介入治疗（PCI）术后支架内再狭窄的价值。方法　本研究为回顾性分析。收集2019年7月至2022年1月在汉中市人民医院接受PCI术的100例急性心肌梗死患者临床资料。根据患者术后6个月内是否出现支架内再狭窄，将其分为再狭窄组（30例）和未狭窄组（70例）。比较两组患者的左心室功能和同步性参数。利用Lasso回归模型筛选再狭窄的关键特征变量，并通过受试者操作特征曲线（ROC）、校正曲线和决策曲线分析（DCA）评估变量的临床应用价值。采用独立样本t检验、χ²检验进行统计分析。结果　再狭窄组的左心室舒张末期容积（LVEDV）高于未狭窄组［（142.07±28.62）ml比（113.83±32.55）ml］，左心室射血分数（LVEF）、高峰射血速率（PER）/舒张末期容积（EDV）、高峰充盈速率（PFR）/EDV均低于未狭窄组［（46.77±4.26）%比（49.84±4.26）%）、（1.89±0.62）L/s比（2.47±0.87）L/s、（1.36±0.45）L/s比（1.77±0.68）L/s］，差异均有统计学意义（t=4.335、-3.312、-3.794、-3.598，均P<0.001）。通过Lasso回归分析对支架内再狭窄的特征变量进行筛选，得到5个特征变量，分别为LVEDV、LVEF和16段心肌达到最小收缩容积的时间标准差（Tmsv16-SD/R-R）、12段心肌达到最小收缩容积的时间标准差（Tmsv12-SD/R-R）、经心率校正的12段心肌达到最小收缩容积的时间最大差值（Tmsv12-Dif/R-R）。再狭窄组的风险评分低于未狭窄组［（0.02±0.99）分比（1.54±1.07）分］，差异有统计学意义（t=6.653，P<0.001）。ROC分析结果显示，Lasso风险评分的曲线下面积为0.866。结论　通过实时三维超声心动图和Lasso回归方法评估急性心肌梗死患者PCI术后的左心室功能和同步性，筛选关键特征变量预测PCI术后支架内再狭窄风险。

关键词:

急性心肌梗死, 经皮冠状动脉介入治疗, 实时三维超声心动图, 支架内再狭窄, 预测

Huang Xinliang, Du Yakun, Ren Hongmei.

Predictive value of real-time 3D echocardiographic parameters for in-stent restenosis after percutaneous coronary intervention in patients with acute myocardial infarction [J]. International Medicine and Health Guidance News, 2025, 31(3): 360-365.

黄新亮杜亚坤任红梅.

实时三维超声心动图参数对急性心肌梗死患者PCI术后支架内再狭窄的预测价值 [J]. 国际医药卫生导报, 2025, 31(3): 360-365.

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