Prediction of Major Adverse Cardiovascular Events Following PCI in NSTEMI Patients Using Combined Myocardial Contrast Echocardiography and Three-dimensional Speckle Tracking Imaging

Ting WEN; Lingjiao ZENG; Ye HUANG; Qingyong QIU; Lingling ZHU

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Ting WEN, Lingjiao ZENG, Ye HUANG, Qingyong QIU, Lingling ZHU. Prediction of Major Adverse Cardiovascular Events Following PCI in NSTEMI Patients Using Combined Myocardial Contrast Echocardiography and Three-dimensional Speckle Tracking Imaging[J]. Journal of Kunming Medical University.

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Prediction of Major Adverse Cardiovascular Events Following PCI in NSTEMI Patients Using Combined Myocardial Contrast Echocardiography and Three-dimensional Speckle Tracking Imaging

1.
Department of Ultrasound Diagnosis
2.
Department of Cardiovascular Medicine，928th Hospital of Joint Support Force of the People’s Liberation Army，Haikou Hainan 570000，China

Received Date: 2025-12-12
Available Online: 2026-03-29

Abstract

Abstract

Objective To investigate the predictive value of myocardial contrast echocardiography （MCE） combined with three-dimensional speckle tracking imaging （3D-STI） for major adverse cardiovascular events （MACEs） following percutaneous coronary intervention （PCI） in patients with non-ST-segment elevation myocardial infarction （NSTEMI）. Methods A total of 254 NSTEMI patients who underwent PCI at the 928th Hospital of the Joint Logistics Support Force, People's Liberation Army from May 2022 to March 2024 were selected. Patients were stratified into MACEs group and non-MACEs group based on the occurrence of MACEs within one year of discharge. Clinical data, conventional echocardiographic parameters, MCE parameters [peak intensity （A）, perfusion score index （PSI）, curve slope （β） and myocardial blood flow （A·β）] and 3D-STI parameters [left ventricular global area strain （LVGAS）, left ventricular global circumferential strain （LVGCS）, left ventricular global longitudinal strain （LVGLS）, left ventricular global radial strain （LVGRS）] were compared between the two groups. The relationships between MCE, 3D-STI parameters and left ventricular ejection fraction （LVEF） were analyzed. Receiver operating characteristic （ROC） curve were used to assess the predictive value of MCE and 3D-STI parameters for MACEs. Results Compared with the non-MACEs group, the MACEs group had higher levels of N-terminal pro-brain natriuretic peptide （NT-proBNP）, interleukin-6 （IL-6）, and soluble suppression of tumorigenicity 2 （sST2）, with lower LVEF and vascular endothelial growth factor （VEGF） levels （P < 0.05）. At 3 months post-operatively, the MACEs group showed lower A, β, A·β values, and higher PSI compared with the non-MACEs group, with significant differences in the changes of A, PSI, β, A·β from 3 months to 24 hours post-operatively between groups （P < 0.05）. At 3 months post-operatively, LVGAS, LVGCS, LVGLS and LVGRS were all lower in the MACEs group than in the non-MACEs group, with significant differences in the changes of these parameters from 3 months to 24 hours post-operatively （P < 0.05）. The combined AUC of MCE and 3D-STI parameters at 3 months post-operatively for predicting MACEs was 0.933 （95%CI: 0.895–0.961）, and the combined AUC using the differences in MCE and 3D-STI parameters between 3 months and 24 hours post-operatively was 0.915 （95%CI: 0.873–0.946）. Conclusion The combined quantitative parameters of MCE and 3D-STI demonstrate high predictive value for MACEs risk following PCI in NSTEMI patients. Monitoring dynamic changes in MCE and 3D-STI parameters from 3 months to 24 hours post-operatively is helpful for early identification of high-risk patients and provides evidence for developing individualized therapeutic and follow-up strategies.

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