■左心房(LA)力学与左心室(LV)充盈密切相关。LA舒张应变斜率(LADSS),跨越被动和主动洛杉矶排空阶段,可能是舒张期LA-LV相互作用的关键指标。
■本研究旨在探讨ST段抬高后心肌梗死(STEMI)中LA-LV的相互依赖性,特别关注LADSS。
■接受原发性经皮冠状动脉介入治疗的前STEMI患者在急性(STEMI后5-9天)和慢性(6个月)阶段接受了对比心脏磁共振成像(MRI)。LADSS分为三组:第1、2和3组,代表阳性,扁平,和负斜率,分别。确定了LADSS组2或3与组1相比的横截面相关性,适应人口统计,LA指数,以及有或没有LV指数。研究了急性期LADSS与LV射血分数(LVEF)和瘢痕量恢复的关系。
■66例急性期(86.4%男性,63.1±11.8年)和59张慢性期心脏MRI图像进行了研究。在急性期,LADSS组1、2和3的分布为24.2%,28.9%,和47.0%,分别,而在慢性期,是33.9%,22.0%,和44.1%,分别。在急性期,LADSS组3的心率高于组1(61.9±8.7vs.73.5±11.9bpm,p<0.01);LVEF较低(48.7±8.6vs.41.8±9.9%,p=0.041)和较弱的LA被动应变率(SR)(-1.1±0.4vs.慢性期-0.7[-1.2至-0.6]s-1,p=0.037)。在调整人口统计学和LA指数后,慢性期3组表现出比1组弱的LA被动SR[相对风险比(RRR)=8.8,p=0.012];较低的LVEF(RRR=0.85,p<0.01),更高的心率(RRR=1.1,p=0.070),在充分调整后,男性的可能性较小(RRR=0.08,p=0.058)。根据人口统计学和LA指数调整后,急性期LADSS组2和3预测LVEF恢复不良;LADSS组2仍然是完全调整模型中的预测因子(β=-5.8,p=0.013)。
■LADSS既可作为当前LV血流动力学的标志物,也可作为前部STEMI后恢复的标志物。LADSS是舒张期LA-LV相互依赖性的重要指标。
■https://clinicaltrials.gov/,标识符NCT03950310。
UNASSIGNED: Left atrial (LA) mechanics are strongly linked with left ventricular (LV) filling. The LA diastasis strain slope (LADSS), which spans between the passive and active LA emptying phases, may be a key indicator of the LA-LV interplay during diastole.
UNASSIGNED: This study aimed to investigate the LA-LV interdependencies in post-ST elevation myocardial infarction (STEMI), with particular focus on the LADSS.
UNASSIGNED: Patients with post-anterior STEMI who received primary percutaneous coronary intervention underwent contrast cardiac magnetic resonance imaging (MRI) during acute (5-9 days post-STEMI) and chronic (at 6 months) phases. The LADSS was categorized into three groups: Groups 1, 2, and 3 representing positive, flat, and negative slopes, respectively. Cross-sectional correlates of LADSS Group 2 or 3 compared to Group 1 were identified, adjusting for demographics, LA indices, and with or without LV indices. The associations of acute phase LADSS with the recovery of LV ejection fraction (LVEF) and scar amount were investigated.
UNASSIGNED: Sixty-six acute phase (86.4% male, 63.1 ± 11.8 years) and 59 chronic phase cardiac MRI images were investigated. The distribution across LADSS Groups 1, 2, and 3 in the acute phase was 24.2%, 28.9%, and 47.0%, respectively, whereas in the chronic phase, it was 33.9%, 22.0%, and 44.1%, respectively. LADSS Group 3 demonstrated a higher heart rate than Group 1 in the acute phase (61.9 ± 8.7 vs. 73.5 ± 11.9 bpm, p < 0.01); lower LVEF (48.7 ± 8.6 vs. 41.8 ± 9.9%, p = 0.041) and weaker LA passive strain rate (SR) (-1.1 ± 0.4 vs. -0.7 [-1.2 to -0.6] s-1, p = 0.037) in the chronic phase. Chronic phase Group 3 exhibited weaker LA passive SR [relative risk ratio (RRR) = 8.8, p = 0.012] than Group 1 after adjusting for demographics and LA indices; lower LVEF (RRR = 0.85, p < 0.01), higher heart rate (RRR = 1.1, p = 0.070), and less likelihood of being male (RRR = 0.08, p = 0.058) after full adjustment. Acute phase LADSS Groups 2 and 3 predicted poor recovery of LVEF when adjusted for demographics and LA indices; LADSS Group 2 remained a predictor in the fully adjusted model (β = -5.8, p = 0.013).
UNASSIGNED: The LADSS serves both as a marker of current LV hemodynamics and its recovery in post-anterior STEMI. The LADSS is an important index of LA-LV interdependency during diastole.
UNASSIGNED: https://clinicaltrials.gov/, identifier NCT03950310.