组织多普勒成像联合心肌声学造影对经皮冠状动脉介入治疗术后心肌微循环的预测价值OA

Objective To explore the value of tissue Doppler imaging(TDI)combined with myocardial contrast echocardiography(MCE)in predicting myocardial microcirculation after percutaneous coronary intervention(PCI).Methods Data of 93 patients with myocardial infarction who underwent PCI treatment at the First People's Hospital of Huzhou from March 2023 to March 2025 were collected.All patients received TDI and MCE examinations within 12 hours after PCI,and coronary angiography was performed one week after the operation.Complete patient data were obtained through the hospital's electronic medical record system.Postoperative myocardial microcirculation was evaluated based on the microcirculation resistance index,and patients were divided into the occurrence group(26 cases)and the non-occurrence group(67 cases).The general data,TDI quantitative parameters within 12 hours after the operation[peak systolic velocity of the lateral wall(Vs)and of the interventricular septum(Vs'),early diastolic peak velocity of the lateral wall(Ve)and of the septum(Ve'),late diastolic peak velocity of the lateral wall(Va)and of the septum(Va'),the calculated Ve/Va ratios(for both lateral wall and septum),and the Tei index],as well as MCE quantitative parameters[peak intensity of the plateau phase(A value),slope of curve rise(β value),and myocardial blood flow(A×β value)]were compared between the two groups.Multivariate Logistic regression analysis was used to screen influencing factors for myocardial microcirculation dysfunction after PCI.ROC curve was drawn to analyze the predictive efficacy of TDI and MCE parameters alone and in combination for postoperative myocardial microcirculation dysfunction in patients undergoing PCI.Results The Tei index was higher,while Ve',Ve,Ve/Va,A value,β value,and A×β value were all lower in the occurrence group than in the non-occurrence group(t=2.807,5.892,4.242,3.231,3.106,2.806,2.285;all P<0.05).Logistic regression analysis showed that Tei,Ve',Ve,Ve/Va,A value,β value,and A×β value were all influencing factors for the occurrence of myocardial microcirculation dysfunction after PCI.The AUC of each parameter alone and in combination in predicting myocardial microcirculation dysfunction in patients after PCI was 0.675,0.803,0.723,0.687,0.692,0.671,0.644,and 0.933,respectively.The value of combined prediction was higher.Conclusion TDI combined with MCE can effectively predict myocardial microcirculation dysfunction in patients after PCI and has high clinical value.