Abstract:
Objective To investigate the early warning value of myocardial angiography (MCE) for heart failure after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).
Methods A total of 146 AMI patients scheduled for PCI in Neijiang First People's Hospital were selected, and divided into groups based on whether heart failure occurred after 6 months of operation. The general data and echocardiographic parameters and MCE quantitative parameterscontrast agent filling rate (β), maximum number of microbubbles in contrast agent (A), myocardial blood flow (MBF) at 1d before the operation were compared between two groups. The correlation between echocardiographic parameters and MCE quantitative parameters were analyzed using Pearson, the receiver operating characteristic curve (ROC) was plotted to analyze the predictive efficacy of MCE quantitative parameters, and the area under the curve (AUC) was tested using Delong.
Results Compared with the non-heart failure group, the left ventricular ejection fraction (LVEF), β, A, and MBF in the heart failure group were lower before one day of operation, while the left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) were higher. One day before the operation, the β, A and MBF of patients with heart failure were positively correlated with LVEF (P < 0.01), and negatively correlated with LVESV and LVEDV (P < 0.01). The combined predictive value of MBF + A + β for heart failure occurrence was similar to that of LVEF + LVESV + LVEDV, and superior to the single predictive value of β, A, and MBF (AUC: 0.938 vs 0.937 vs 0.778 vs 0.768 vs 0.821).
Conclusions The levels of β, A and MBF in patients with heart failure after AMI-PCI are lower, which are related to the LVEF, LVESV and LVEDV. Combined detection is helpful to improve the predictive efficacy of heart failure and guide clinical decision-making.