三维超声心动图结合甘油三酯-葡萄糖指数评估经皮冠状动脉介入术后患者长期预后的评估价值

Xuan Luo, Yaoyao Deng, Lijuan Gu
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Patients with cardiovascular events were assigned to the exposed group, while those without cardiovascular events were included in the nonexposed group. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular mass index (LVMI), left ventricular remodeling index (LVRI), left ventricular ejection fraction (LVEF), standard deviation of time to peak of left ventricular 16 segments (Tmsv16-SD), maximum time difference (Tmsv16-Dif), and difference between the 3DE index and the TYG index were collected. Logistic regression analysis was performed on the indicators with differences to analyze the influencing factors of the long-term prognosis of patients after PCI. The receiver operating characteristic (ROC) curve was drawn. The sensitivity, specificity, area under the curve (AUC), and Youden index were calculated. The best predictive cutoff value was determined. The predictive value of the 3DE index and the TYG index, either alone or in combination, was observed for long-term prognosis after PCI. The relationship between the 3DE index and the TYG index was explored. Result: The 2-year follow-up results showed that 22 patients experienced cardiovascular events, and they were included in the exposed group, accounting for 21.57%. The remaining 80 patients without cardiovascular events were included in the nonexposed group, accounting for 78.43%. A significant difference was found in creatinine (Cr), high-density lipoprotein cholesterol (HDL-C), LVEDV, LVESV, LVMI, LVRI, LVEF, Tmsv16-SD, Tmsv16-Dif, and the TYG index between the exposed group and nonexposed group (p < 0.05). Cr, HDL-C, LVEDV, LVESV, LVMI, Tmsv16-SD, Tmsv16-Dif, and the TYG index in the exposed group were higher than those in the nonexposed group (p < 0.05). The exposed group also had lower LVRI and LVEF than the nonexposed group (p < 0.05). Logistic regression analysis of the indicators with differences showed that Cr, HDL-C, LVEDV, LVESV, LVMI, LVRI, LVEF, Tmsv16-SD, Tmsv16-Dif, and the TYG index were the major factors that affect the long-term prognosis of patients after PCI, with odds ratio values >1. Correlation analysis showed that the TYG index was positively correlated with LVEDV, LVESV, LVMI, Tmsv16-SD, Tmsv16-Dif, and the TYG index (r = 0.565, 0.678, 0.696, 0.702, 0.788, 0.804, p < 0.05). Moreover, it was negatively correlated with LVRI and LVEF (r = –0.580, –0.674, p < 0.05). The sensitivity and specificity of the 3DE index combined with the TYG index in predicting long-term prognosis after PCI were 0.818 and 0.950, respectively, which were significantly higher than those of the 3DE index or the TYG index alone. The Youden index was 0.768, the AUC value was 0.922, and the optimal threshold was 36.64. Conclusion: The 3DE index and the TYG index were influencing factors for the long-term prognosis of patients after PCI, and a correlation existed between the 3DE index and the TYG index. 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Conclusion: The 3DE index and the TYG index were influencing factors for the long-term prognosis of patients after PCI, and a correlation existed between the 3DE index and the TYG index. 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引用次数: 0

摘要

研究目的本研究分析了三维超声心动图(3DE)与甘油三酯-葡萄糖(TYG)指数的结合,以评估经皮冠状动脉介入治疗(PCI)后患者的长期预后。研究方法回顾性分析我院2020年1月至2020年12月收治的102例PCI患者的临床资料。对所有患者进行了 24 个月的随访,以评估其长期预后。所有患者的心脑血管事件发生情况均有记录。心血管和脑血管事件是指心脏和脑血管系统的一系列疾病或状况,包括心脏性猝死。有心脑血管事件的患者被归入暴露组,而没有心脑血管事件的患者被归入非暴露组。收集了左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室质量指数(LVMI)、左心室重塑指数(LVRI)、左心室射血分数(LVEF)、左心室16节段达到峰值时间的标准偏差(Tmsv16-SD)、最大时间差(Tmsv16-Dif)以及3DE指数和TYG指数之间的差异。对有差异的指标进行逻辑回归分析,以分析 PCI 术后患者长期预后的影响因素。绘制接收器操作特征曲线(ROC)。计算灵敏度、特异性、曲线下面积(AUC)和尤登指数。确定了最佳预测截断值。观察了 3DE 指数和 TYG 指数单独或组合对 PCI 后长期预后的预测价值。探讨了 3DE 指数和 TYG 指数之间的关系。结果:2 年随访结果显示,22 名患者发生了心血管事件,他们被纳入暴露组,占 21.57%。其余 80 例未发生心血管事件的患者被纳入非暴露组,占 78.43%。在肌酐(Cr)、高密度脂蛋白胆固醇(HDL-C)、LVEDV、LVESV、LVMI、LVRI、LVEF、Tmsv16-SD、Tmsv16-Dif 和 TYG 指数方面,暴露组和非暴露组之间存在明显差异(P < 0.05)。暴露组的 Cr、HDL-C、LVEDV、LVESV、LVMI、Tmsv16-SD、Tmsv16-Dif 和 TYG 指数均高于非暴露组(P < 0.05)。暴露组的 LVRI 和 LVEF 也低于非暴露组(P < 0.05)。对存在差异的指标进行的逻辑回归分析表明,Cr、HDL-C、LVEDV、LVESV、LVMI、LVRI、LVEF、Tmsv16-SD、Tmsv16-Dif和TYG指数是影响PCI术后患者长期预后的主要因素,其几率值均大于1。相关分析显示,TYG 指数与 LVEDV、LVESV、LVMI、Tmsv16-SD、Tmsv16-Dif 和 TYG 指数呈正相关(r = 0.565、0.678、0.696、0.702、0.788、0.804,P < 0.05)。此外,它与 LVRI 和 LVEF 呈负相关(r = -0.580, -0.674, p < 0.05)。3DE指数与TYG指数联合预测PCI术后长期预后的敏感性和特异性分别为0.818和0.950,明显高于单独使用3DE指数或TYG指数。Youden指数为0.768,AUC值为0.922,最佳阈值为36.64。结论3DE指数和TYG指数是PCI术后患者长期预后的影响因素,3DE指数和TYG指数之间存在相关性。3DE指数与TYG指数相结合可提高PCI术后患者长期预后的预测效率。
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Appraised Value of 3D Echocardiography Combined with the Triglyceride–Glucose Index to Evaluate the Long-Term Prognosis of Patients after Percutaneous Coronary Intervention
Objective: This study analyzed three-dimensional echocardiography (3DE) combined with the triglyceride–glucose (TYG) index to evaluate the long-term prognosis of patients after percutaneous coronary intervention (PCI). Methods: The clinical data of 102 patients who were treated with PCI after admission to our hospital from January 2020 to December 2020 were retrospectively analyzed. All the patients were followed up for 24 months to evaluate their long-term prognosis. The occurrence of cardiovascular and cerebrovascular events in all the patients was recorded. Cardiovascular and cerebrovascular events refer to a series of diseases or conditions of the heart and the cerebrovascular system, including sudden cardiac death. Patients with cardiovascular events were assigned to the exposed group, while those without cardiovascular events were included in the nonexposed group. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular mass index (LVMI), left ventricular remodeling index (LVRI), left ventricular ejection fraction (LVEF), standard deviation of time to peak of left ventricular 16 segments (Tmsv16-SD), maximum time difference (Tmsv16-Dif), and difference between the 3DE index and the TYG index were collected. Logistic regression analysis was performed on the indicators with differences to analyze the influencing factors of the long-term prognosis of patients after PCI. The receiver operating characteristic (ROC) curve was drawn. The sensitivity, specificity, area under the curve (AUC), and Youden index were calculated. The best predictive cutoff value was determined. The predictive value of the 3DE index and the TYG index, either alone or in combination, was observed for long-term prognosis after PCI. The relationship between the 3DE index and the TYG index was explored. Result: The 2-year follow-up results showed that 22 patients experienced cardiovascular events, and they were included in the exposed group, accounting for 21.57%. The remaining 80 patients without cardiovascular events were included in the nonexposed group, accounting for 78.43%. A significant difference was found in creatinine (Cr), high-density lipoprotein cholesterol (HDL-C), LVEDV, LVESV, LVMI, LVRI, LVEF, Tmsv16-SD, Tmsv16-Dif, and the TYG index between the exposed group and nonexposed group (p < 0.05). Cr, HDL-C, LVEDV, LVESV, LVMI, Tmsv16-SD, Tmsv16-Dif, and the TYG index in the exposed group were higher than those in the nonexposed group (p < 0.05). The exposed group also had lower LVRI and LVEF than the nonexposed group (p < 0.05). Logistic regression analysis of the indicators with differences showed that Cr, HDL-C, LVEDV, LVESV, LVMI, LVRI, LVEF, Tmsv16-SD, Tmsv16-Dif, and the TYG index were the major factors that affect the long-term prognosis of patients after PCI, with odds ratio values >1. Correlation analysis showed that the TYG index was positively correlated with LVEDV, LVESV, LVMI, Tmsv16-SD, Tmsv16-Dif, and the TYG index (r = 0.565, 0.678, 0.696, 0.702, 0.788, 0.804, p < 0.05). Moreover, it was negatively correlated with LVRI and LVEF (r = –0.580, –0.674, p < 0.05). The sensitivity and specificity of the 3DE index combined with the TYG index in predicting long-term prognosis after PCI were 0.818 and 0.950, respectively, which were significantly higher than those of the 3DE index or the TYG index alone. The Youden index was 0.768, the AUC value was 0.922, and the optimal threshold was 36.64. Conclusion: The 3DE index and the TYG index were influencing factors for the long-term prognosis of patients after PCI, and a correlation existed between the 3DE index and the TYG index. The 3DE index combined with the TYG index can improve the predictive efficiency of the long-term prognosis of patients after PCI.
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