Beijing Da Xue Xue Bao Yi Xue Ban. 2026 Oct 18;58(5):987-991.
ABSTRACT
OBJECTIVE: To investigate the correlation between angio-based microvascular resistance (AMR) and impaired left ventricular systolic function in patients with acute ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI), and to assess its predictive value for left ventricular systolic function.
METHODS: A study was conducted, enrolling consecutive STEMI patients who underwent primary PCI at the Department of Cardiology, Peking University Third Hospital from May 2023 to June 2024. Quantitative flow ratio (QFR) and AMR were calculated from coronary angiography images immediately after PCI, and myocardial biomarker or left ventricular ejection fraction (LVEF) assessed by echocardiography at half-year follow-up were collected. The correlation between AMR, QFR, myocardial biomarkers, and LVEF after half a year was analyzed. The STEMI patients were divided into normal or reduced left ventricular systolic function with LVEF 0.5 as the boundary. The accuracy of AMR in diagnosing reduced left ventricular systolic function was analyzed by receiver operating characteristic curve (ROC).
RESULTS: A total of 194 patients were enrolled, with an average age of (63.3±13.6) years, and the average AMR value was (246.99±57.18) mmHg·s/m. Age, peak creatine kinase (CK), troponin T (TnT), N-terminal pro-brain natriuretic peptide (NT-proBNP), and AMR were identified as independent predictive factors for LVEF at half-year follow-up (β=-0.160, t=-2.533, P=0.012; β=-0.271, t=-3.068, P=0.002; β=-0.191, t=-2.157, P=0.032; β=-0.280, t=-4.515, P < 0.001; β=-0.162, t=-2.711, P=0.007). ROC curve analysis showed that AMR had a certain value in predicting reduced left ventricular systolic function [area under curve (95% confidence interval) was 0.631 (0.543-0.718), P=0.006], and the optimal cut-off value for predicting an LVEF < 0.5 was 250.5 mmHg·s/m.
CONCLUSION: AMR is an independent predictor of LVEF at half-year post-procedure and has significant predictive value for reduced left ventricular systolic function, potentially playing an important role in predicting the prognosis of STEMI patients.
PMID:42880919