GIÁ TRỊ DỰ BÁO BIẾN CỐ TIM MẠCH CHÍNH CỦA SỨC CĂNG NHĨ TRÁI Ở BỆNH NHÂN NHỒI MÁU CƠ TIM CẤP ĐƯỢC CAN THIỆP ĐỘNG MẠCH VÀNH QUA DA

Abstract

Objective: To evaluate the value of left atrial (LA) strain in predicting major adverse cardiac event (MACE) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Subjects and methods: Prospective study in 120 patients with AMI undergoing PCI. Speckle tracking echocardiography (STE) with LA strain measurements was performed within 24 hours of admission. Patients were followed for 12 months, recording major adverse cardiovascular events - MACE (all-cause death, hospitalization for heart failure, recurrent myocardial infarction, coronary artery restenosis, coronary artery bypass grafting, stroke). Results: Left atrial strain reservoir (LASr), left atrial strain conduit (LAScd), and left atrial strain contraction (LASct) were significantly lower in the group with MACE than in the group without MACE. Univariate Cox regression analysis showed that all left atrial strain indices had predictive value for MACE. Multivariate Cox regression analysis showed that LASr (HR 0.94, [95% CI: 0.90-0.99], p = 0.038) and LAScd (HR 0.89, [95% CI: 0.81-0.99], p = 0.032) were independent predictors of MACE in patients with AMI. LASr (AUC = 0.697, 95% CI, p = 0.004) and LAScd (AUC = 0.705, 95% CI, p = 0.003) had better predictive value for MACE than LVEF (AUC = 0.674, 95% CI, p = 0.011). The optimal cut-off values ​​of LASr were 21.1%, LAScd was 12.2%, and LASct was 8.7% to differentiate the high-risk and low-risk groups for MACE. Conclusion: Left atrial strain is an independent predictor of major adverse cardiovascular events in patients with AMI. Left atrial strain reservoir and left atrial strain conduit have better predictive value for MACE than LVEF.