Biomarker combination for predicting PCI postoperative LVR of STEMI patient and application of biomarker combination

Abstract

The invention discloses a biomarker combination for predicting PCI postoperative LVR of an STEMI patient and application of the biomarker combination, and belongs to the technical field of biology. The research discovers that in a left ventricular remodeling (LVR) group and a non-left ventricular remodeling group after percutaneous coronary intervention (PCI) of a patient suffering from acute ST segment elevation type myocardial infarction (STEMI), a left ventricular endocardial lower myocardial overall longitudinal strain (GLS internal) value, a lung B-line integral, a serum sFRP5 level and Apelin-13 show significant differences. Through combined prediction analysis, it is found that the GLS internal value, the lung B-line integral, the serum sFRP5 and the Apelin-13 have excellent prediction performance on whether the LVR occurs after the PCI operation of the STEMI patient or not, high-risk groups, suffering from the LVR after the PCI operation, of the STEMI patient can be accurately and efficiently recognized, intervention is conducted as soon as possible, and the life quality of the patient is expected to be improved.

Description

Technical Field

[0001] This invention relates to the field of biotechnology, and in particular to a combination of biomarkers for predicting LVR after PCI in STEMI patients and their application. Background Technology

[0002] Acute ST-segment elevation myocardial infarction (STEMI) is one of the most critical types of coronary artery disease in clinical practice. Its rapid onset and progression have made it a significant cause of cardiovascular-related mortality. Percutaneous coronary intervention (PCI) is the core method for revascularization in STEMI patients, rapidly restoring blood flow to the infarct-related artery, reducing the infarct size, significantly lowering in-hospital mortality, and improving short-term prognosis. However, 20%-30% of STEMI patients develop left ventricular remodeling (LVR) post-procedure, characterized by increased left ventricular end-diastolic volume, thinning of the ventricular wall, and decreased systolic function. LVR is a key risk factor for long-term adverse cardiovascular events such as heart failure and arrhythmias; therefore, predicting LVR is crucial for optimizing clinical intervention strategies.

[0003] However, there are currently few biomarkers available for predicting LVR, especially in predicting LVR after PCI in STEMI patients. Existing biomarkers have limited predictive efficacy, and there is an urgent need to develop new predictive biomarkers or methods. Summary of the Invention

[0004] The purpose of this invention is to provide a combination of biomarkers for predicting left ventricular remodeling (LVR) after percutaneous coronary intervention (PCI) in STEMI patients and its application, thereby addressing the problems existing in the prior art. This invention found that in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing PCI, significant differences were observed in the global longitudinal strain (GLS) value of the subendocardial myocardium of the left ventricle, the lung B-line score, serum sFRP5 levels, and Apelin-13 levels. Combined predictive analysis revealed that the GLS value, lung B-line score, combined with serum sFRP5 and Apelin-13, exhibit excellent predictive performance in determining whether LVR will occur in STEMI patients after PCI. This is beneficial for accurately and efficiently identifying high-risk individuals for LVR after PCI in STEMI patients, enabling early intervention and ultimately improving patients' quality of life.

[0005] To achieve the above objectives, the present invention provides the following solution:

[0006] This invention provides a combination of biomarkers for predicting LVR after PCI in STEMI patients, the combination of biomarkers including global longitudinal strain value of the subendocardial myocardium of the left ventricle, lung B-line integral, serum sFRP5 and serum Apelin-13.

[0007] Furthermore, the total longitudinal strain value of the subendocardial myocardium of the left ventricle and the integral of the lung B-line were measured using multimodal ultrasound technology.

[0008] Furthermore, the total longitudinal strain value of the subendocardial myocardium of the left ventricle and the lung B-line integral were measured within 1 week after PCI.

[0009] The serum sFRP5 and serum Apelin-13 were measured within 24 hours before PCI.

[0010] The present invention also provides the use of the above-mentioned combination of biomarkers in the preparation of products for predicting LVR after PCI in STEMI patients.

[0011] Optionally, the product may include instruments, reagents, or kits.

[0012] The present invention also provides a product for predicting LVR after PCI in STEMI patients, the product comprising an instrument, reagent or kit for detecting global longitudinal strain value of the subendocardial myocardium of the left ventricle, lung B-line integral, serum sFRP5 and serum Apelin-13.

[0013] The present invention also provides the application of the above-mentioned combination of biomarkers in constructing a predictive model product for LVR after PCI in STEMI patients.

[0014] The present invention discloses the following technical effects:

[0015] This study found that in patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI), there were significant differences in the global longitudinal strain (GLS) value of the subendocardial myocardium of the left ventricle and the lung B-line score detected by multimodal ultrasound in the LVR group and the non-LVR group. The LVR group had a lower global longitudinal strain (GLS) value of the subendocardial myocardium of the left ventricle and a higher lung B-line score within 1 week after PCI. Serum sFRP5 level and Apelin-13 also showed significant differences between the two groups. Compared with the non-LVR group, the LVR group had higher serum sFRP5 level and lower Apelin-13 level. Joint predictive analysis revealed that the area under the curve (AUC) of multimodal ultrasound-detected indicators—left ventricular subendocardial myocardial global longitudinal strain (GLS), lung B-line score, combined with serum sFRP5 and Apelin-13—for predicting post-PCI LVR in STEMI patients reached 0.905, with a sensitivity of 92.16% and a specificity of 88.29%, demonstrating excellent predictive performance significantly higher than that of single indicators. This invention provides a novel combination of biomarkers for the prediction and assessment of post-PCI LVR in STEMI patients, facilitating more accurate and efficient identification of high-risk individuals for adverse events after PCI in STEMI patients, enabling early intervention and ultimately improving patients' quality of life. Detailed Implementation

[0016] Various exemplary embodiments of the present invention will now be described in detail. This detailed description should not be considered as a limitation of the present invention, but rather as a more detailed description of certain aspects, features, and embodiments of the present invention.

[0017] It should be understood that the terminology used in this invention is merely for describing particular embodiments and is not intended to limit the invention. Furthermore, with respect to numerical ranges in this invention, it should be understood that each intermediate value between the upper and lower limits of the range is also specifically disclosed. Any stated value or intermediate value within a stated range, as well as each smaller range between any other stated value or intermediate value within said range, is also included in this invention. The upper and lower limits of these smaller ranges may be independently included or excluded from the range.

[0018] Unless otherwise stated, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art. While only preferred methods and materials have been described herein, any methods and materials similar or equivalent to those described herein may be used in the implementation or testing of this invention. All references to this specification are incorporated by way of citation to disclose and describe methods and / or materials associated with those references. In the event of any conflict with any incorporated reference, the content of this specification shall prevail.

[0019] Various modifications and variations can be made to the specific embodiments described in this specification without departing from the scope or spirit of the invention, as will be apparent to those skilled in the art. Other embodiments derived from this specification will also be apparent to those skilled in the art. This specification and embodiments are merely exemplary.

[0020] The terms “include,” “including,” “have,” “contain,” etc., used in this article are all open-ended terms, meaning that they include but are not limited to.

[0021] Research idea of ​​this invention:

[0022] This invention integrates conventional echocardiography, speckle tracking, myocardial contrast imaging, and lung ultrasound into a multimodal ultrasound system, combined with serological testing, for post-PCI evaluation in acute myocardial infarction. The specific research approach is as follows:

[0023] (1) Comprehensive information collection

[0024] Routine echocardiography: As a basic examination method, it provides overall structural and functional information about the heart, including fundamental parameters such as ventricular size, wall thickness, valvular activity, intracardiac blood flow, and left ventricular ejection fraction. This data helps to initially understand the heart's overall recovery after PCI and to determine if there are any significant structural abnormalities or functional impairments.

[0025] Two-dimensional speckle tracking technology: This technology can track the movement trajectory of myocardial tissue in real time, accurately measure myocardial systolic and diastolic function, and assess myocardial strain and strain rate. It can detect subtle changes in early myocardial function, capturing signs of potential myocardial damage or dysfunction even before conventional ultrasound shows obvious abnormalities, providing a more sensitive indicator for efficacy assessment.

[0026] Myocardial acoustic contrast imaging: This technique uses microbubble contrast agents to enhance ultrasound signals, clearly displaying the blood perfusion within the myocardium. After PCI in acute myocardial infarction, it can accurately assess the reperfusion effect in the infarct-related area, observe whether there is no reflow, and the establishment of collateral circulation, thus directly reflecting the degree of improvement in myocardial blood supply. This is of great significance for determining the success of the surgery and prognosis.

[0027] Lung ultrasound: Due to the close physiological connection between the heart and lungs, lung ultrasound can indirectly reflect the functional status of the heart. For example, it can observe the presence and severity of pulmonary edema, as heart failure may occur after PCI, leading to pulmonary congestion and edema; it can also detect pleural effusion, etc., all of which are closely related to cardiac function, thus assisting in the overall assessment of the efficacy of PCI from another perspective.

[0028] Serological testing: Secreted frizzled related protein 5 (sFRP5) is a novel anti-inflammatory adipokines widely distributed in adipose tissue, pancreas, cardiomyocytes, and other cells. It has good anti-inflammatory effects and participates in inflammatory responses and blood glucose regulation. Previous studies have suggested that abnormal levels of sFRP5 are closely related to myocardial injury. Apelin-13, an endogenous active peptide, has protective effects on vascular endothelium and improves myocardial remodeling. Low expression of apelin-13 often indicates a poor prognosis in STEMI patients.

[0029] (2) Multidimensional analysis and complementary verification

[0030] Combining the cardiac structural information provided by conventional echocardiography with the myocardial function information reflected by speckle tracking technology allows for both an understanding of cardiac morphological changes and a deeper exploration of the causes and mechanisms of functional alterations. For example, when abnormal wall motion is detected in a certain segment, speckle tracking can further quantify the degree of myocardial strain in that area, clarifying whether there is actual myocardial ischemia or necrosis leading to functional impairment. The blood perfusion data displayed by myocardial contrast echocardiography corroborate the myocardial mechanical motion observed by conventional echocardiography and speckle tracking. Abnormal findings from lung ultrasound (such as pulmonary edema and pleural effusion) are comprehensively analyzed with cardiac function indicators to fully assess the circulatory status and compensatory capacity of patients after PCI.

[0031] (3) Dynamic monitoring and follow-up

[0032] Multimodal ultrasound examinations are performed within the first week and 6 months after PCI to observe the trends of various indicators. This helps physicians understand the progression of treatment effectiveness, identify potential complications (such as restenosis, thrombosis, and arrhythmias), and take prompt intervention measures. Regular long-term follow-up is conducted to continuously monitor the recovery of cardiac structure and function. By comparing follow-up examination results, the long-term efficacy of PCI treatment can be assessed, patient prognosis predicted, and a basis for subsequent treatment decisions provided. Based on the comprehensive assessment results of multimodal ultrasound, combined with the patient's clinical symptoms, serological tests, laboratory tests, and other imaging data, a personalized treatment plan is developed for each patient. For patients with poor response, drug dosage, type, or treatment method are adjusted promptly; for patients at risk of specific complications, preventive measures are taken in advance. Multimodal ultrasound is used as a feedback tool for treatment effectiveness to continuously optimize treatment plans.

[0033] (4) Quality control and standardized operation

[0034] Establish unified operating procedures for multimodal ultrasound examinations to ensure consistency and comparability among different operators. This includes standardized settings for probe position, angle, scanning range, and image acquisition parameters, as well as the appropriate application sequence and methods for various techniques. Utilize professional software tools to analyze and process multimodal ultrasound data, and develop standardized analysis methods and reference ranges. Simultaneously, strengthen the training and assessment of technical personnel to improve the accuracy and reliability of data analysis.

[0035] Previous studies of this invention have found that some multimodal ultrasound detection indicators and the levels of markers such as serum sFRP5 and serum Apelin-13 differed significantly between STEMI patients who developed LVR after PCI and those who did not. To verify the diagnostic performance of these indicators in LVR after PCI in STEMI patients, this invention constructed an independent cohort and conducted verification studies in the following embodiments.

[0036] Example 1

[0037] 1. Materials and Methods

[0038] 1.1 General Information

[0039] With the approval of the Medical Ethics Committee of Xuzhou Central Hospital Affiliated to Southeast University, 162 STEMI patients who underwent PCI treatment were selected, admitted between April 2023 and March 2025. The inclusion and exclusion criteria are as follows:

[0040] Inclusion criteria for cases: (1) meeting the relevant diagnostic criteria for STEMI; (2) aged 18-80 years; (3) first diagnosis of STEMI, typical chest pain onset ≤12h, electrocardiogram showing ST segment elevation (≥0.2mV in chest leads or ≥0.1mV in limb leads), and elevated peak serum troponin I (cTnI); (4) first PCI treatment; (5) sinus rhythm (heart rate 60-100 beats / min), and clear ultrasound image quality; (6) written consent signed by the patient and family.

[0041] Exclusion criteria: (1) Old myocardial infarction or recurrent acute myocardial infarction; (2) Previous PCI or coronary artery bypass grafting; (3) Comorbid other types of heart disease (acute heart failure, cardiogenic shock, hypertrophic cardiomyopathy, congenital heart disease, etc.); (4) Severe liver and kidney dysfunction, active bleeding, or contrast agent allergy; (5) History of severe infection, major surgery, trauma, or cardiopulmonary resuscitation within the past 3 months; (6) Thrombolytic therapy before PCI or unsuccessful PCI; (7) Comorbid other malignant tumors; (8) Mental and cognitive impairment that prevents cooperation with follow-up and examination.

[0042] Based on whether left ventricular remodeling (LVR) occurred postoperatively, all patients were divided into a left ventricular remodeling group (LVR group, n=51) and a non-LVR group (n=111). In the LVR group, there were 40 males and 11 females, aged 36-78 years (mean age 58.62±9.37 years), with a BMI of 20-26 kg / m². 2 The average weight was (23.90±2.12) kg / m³. 2 Underlying diseases: hypertension in 17 cases, diabetes in 18 cases, and hyperlipidemia in 22 cases; in the non-LVR group, there were 91 males and 20 females, aged 36-77 years, with a mean age of (57.25±8.81) years and a BMI of 21-25 kg / m². 2 The average weight was (23.85±2.27) kg / m³. 2 Underlying diseases: 37 cases of hypertension, 40 cases of diabetes, and 48 cases of hyperlipidemia. There were no significant differences between the two groups in terms of age, sex, BMI, and underlying diseases (P>0.05).

[0043] 1.2 Methods

[0044] 1.2.1 PCI surgical method

[0045] All patients underwent PCI treatment by the same team of cardiologists, using Judkins catheters for multi-angle, multi-planar selective coronary angiography to ensure full visualization of all coronary artery segments. Visually, vessels with ≥50% stenosis were identified as diseased vessels, and those with ≥70% stenosis as target vessels. Electrocardiograms and echocardiograms were used to determine the infarct-related lesions. Stent implantation: Based on the target vessel diameter (2.5-4.0 mm) and stenosis length, a matching drug-eluting stent was selected. After balloon pre-dilation at 2.0-3.0 atm, the stent was implanted. Post-operatively, in-stent posterior dilation was performed at 3.0-4.0 atm to ensure good stent apposition. Successful procedure criteria: Coronary angiography showing residual stenosis <20% in the diseased vessel; TIMI flow grade III; significant improvement in chest pain symptoms reported by the patient; and no acute complications.

[0046] 1.2.2 Data Collection

[0047] Collect data on all patients' gender, age, body mass index, underlying diseases, Killip grade ≥2, number of diseased vessels, infarct area, and laboratory indicators (serum high-sensitivity troponin I (hs-cTnL) and creatine kinase (CK) within 24 hours before surgery).

[0048] 1.2.3 Measurement of serum sFRP5 and Apelin-13 levels

[0049] Within 24 hours prior to PCI, 5 mL of venous blood was collected. The blood sample was centrifuged at a centrifuge radius of 10 cm and a speed of 3000 rpm for 10 min. After centrifugation, the serum component from the supernatant was extracted and stored at -80℃ for later analysis. Serum sFRP5 and Apelin-13 levels were measured using enzyme-linked immunosorbent assay (ELISA). Kits were purchased from Shanghai Zhenke Biotechnology Co., Ltd. and Shanghai Lianmai Biotechnology Co., Ltd. (catalog numbers: XK-E1564h and XK-E1060h).

[0050] 1.2.4 Multimodal ultrasound examination

[0051] Multimodal ultrasound examination was performed within one week after PCI using a color Doppler ultrasound diagnostic instrument (Philips Epiq7C model) with S5-1 and C5-1 probes at a frequency of 1.5-4.5 MHz. Transthoracic echocardiography (TTE) was performed with the patient in the left lateral decubitus position, breathing quietly, and an electrocardiogram was simultaneously connected. The left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left atrial volume index (LAVI) were measured using the biplane Simpson method. Two-dimensional speckle tracking imaging (2D-STI): Dynamic images of the apical four-chamber, three-chamber, and two-chamber views (frame rate > 50 Hz) were acquired and imported into the Qlab10.8 workstation to calculate the left ventricular global longitudinal strain (GLS) values ​​of the subendocardial myocardium, mid-layer myocardium, and subepicardial myocardium. Lung ultrasound: The patient was placed in a supine position, and the chest wall was divided into 8 zones with the left and right anterior axillary lines, posterior axillary lines, and nipple level as boundaries. A C5-1 probe was used to scan along the intercostal spaces, and the number of lung B lines (comet tail sign) in each zone was recorded. The lung B line score was calculated according to the method of Enghard et al. (ENGHARD P, RADEMACHER S, NEE J, et al. Simplified lung ultrasound protocol shows excellent prediction of extravascular lung water inventilated intensive care patients[J]. Crit Care,2015,19(1):36).

[0052] 1.2.5 LVR Diagnostic Criteria

[0053] LVR was defined as an increase of >20% in LVEDV at 6 months post-surgery compared to pre-surgery. All patients were divided into a left ventricular remodeling group (LVR group, n=51) and a non-LVR group (n=111).

[0054] 1.3 Statistical Methods

[0055] Statistical analysis was performed using SPSS 19.0 software. Quantitative data were expressed as (…). Mean ± S) is expressed as mean ± standard deviation. Comparisons between groups were performed using the independent samples t-test. Non-normally distributed data were expressed as median (interquartile range) and analyzed using the Mann-Whitney U test. Count data were expressed as [number of cases (%)], with χ² values ​​per row. 2 The predictive value of multimodal ultrasound combined with serum sFRP5 and Apelin-13 for LVR after PCI in STEMI patients was analyzed by ROC curve analysis. Multivariate logistic regression analysis was performed to analyze the influencing factors of LVR after PCI in STEMI patients. P < 0.05 was considered statistically significant.

[0056] 2. Results

[0057] 2.1 Comparison of general information of patients in LVR group and non-LVR group

[0058] As shown in Table 1, there were no significant differences between the two groups in terms of gender, age, etc. (P>0.05); compared with the non-LVR group, the LVR group had an increased infarct area and a higher proportion of Killip grade ≥2 (P<0.05).

[0059] Table 1 Comparison of general information of patients in the LVR group and non-LVR group

[0060]

[0061] 2.2 Comparison of multimodal ultrasound examination parameters between the two groups

[0062] As shown in Table 2, there were no significant differences in LVEF, GLS extrapolation value, and GLS median value between the two groups before surgery (P>0.05). The preoperative GLS median value was lower in the LVR group than in the non-LVR group, while the LAVI, LVEDV, LVESV, and B-line scores were higher in the LVR group than in the non-LVR group (P<0.05).

[0063] Table 2 Comparison of multimodal ultrasound examination parameters between the two groups

[0064]

[0065] 2.3 Comparison of serum sFRP5 and Apelin-13 levels between the two groups

[0066] As shown in Table 3, compared with the non-LVR group, the serum sFRP5 level was increased and the serum Apelin-13 level was decreased in the LVR group (P<0.05).

[0067] Table 3 Comparison of serum sFRP5 and Apelin-13 levels between the two groups

[0068]

[0069] 2.4 Multivariate Logistic Regression Analysis of LVR after PCI in STEMI Patients

[0070] As shown in Table 4, the dependent variable was whether STEMI patients experienced LVR 6 months after PCI (yes=1, no=0), and the independent variables were Killip grade ≥2 (yes=1, no=0), infarct area, GLS score, B-line score, and serum sFRP5 and Apelin-13 levels (continuous variables). The results showed that LVR in STEMI patients after PCI was multifactorial, including infarct area, GLS score, B-line score, and serum sFRP5 and Apelin-13 levels (all P<0.05).

[0071] Table 4 Multivariate Logistic Regression Analysis of LVR after PCI in STEMI Patients

[0072]

[0073] 2.5 Predictive value of multimodal ultrasound combined with serum sFRP5 and Apelin-13 levels for LVR after PCI in STEMI patients

[0074] As shown in Table 5, the AUCs of serum sFRP5, serum Apelin-13, GLS internal rate, and B-line score independently predicting post-PCI LVR in STEMI patients were 0.793, 0.752, 0.781, and 0.824, respectively. However, the combined AUC of GLS internal rate, B-line score, serum sFRP5, and serum Apelin-13 in predicting post-PCI LVR in STEMI patients was 0.905, exhibiting the highest predictive value (sensitivity 92.16%, specificity 88.29%). This indicates that GLS internal rate, B-line score, serum sFRP5, and serum Apelin-13 have extremely high predictive performance and application value in the combined prediction of post-PCI LVR in STEMI patients.

[0075] Table 5. Predictive value of multimodal ultrasound combined with serum sFRP5 and Apelin-13 levels for LVR after PCI in STEMI patients.

[0076]

[0077] 3. Conclusion

[0078] The above results indicate that, compared with the non-LVR group, patients in the LVR group had lower global longitudinal strain (GLS) values ​​and higher lung B-line scores within one week after PCI, and also had increased infarct area and a higher proportion of Killip grades ≥2. This suggests that multimodal ultrasound can identify high-risk individuals for LVR early through parameters such as GLS values ​​and B-line scores, providing imaging evidence for clinical assessment. Specifically, 2D-STI technology can sensitively capture abnormal longitudinal strain in the myocardium. Since the blood supply to the distal coronary arteries, the subendocardial myocardial fibers of the left ventricle are the first to be damaged and the last to recover during ischemia. A decreased GLS value indicates severe impairment of the contractile function of the subendocardial myocardium. Myocardial infarction leads to extensive myocardial cell necrosis and fibrosis, destroying the normal contractile structure of the myocardium, thereby increasing the risk of LVR. Lung ultrasound B-line scores reflect the degree of pulmonary interstitial edema. The increased B-line scores in the LVR group may be related to the increased left ventricular end-diastolic pressure caused by impaired cardiac pumping function due to acute myocardial infarction, which in turn leads to increased pulmonary venous pressure and capillary leakage, resulting in pulmonary interstitial edema. The increased proportion of Killip grade ≥2 directly indicates more severe cardiac function impairment, increased ventricular wall tension, and further promotion of remodeling.

[0079] Compared with the non-LVR group, the LVR group showed elevated serum sFRP5 levels and decreased apelin-13 levels. Multivariate logistic regression analysis confirmed that both serum sFRP5 and apelin-13 levels were independent risk factors for LVR after PCI in STEMI patients, consistent with their physiological functions and the pathological process of LVR. The elevated sFRP5 levels in the LVR group may be a compensatory response to myocardial ischemia and inflammation. Myocardial infarction triggers a strong inflammatory response, and sFRP5, as an anti-inflammatory factor, is secreted as a feedback mechanism to suppress inflammation. However, when the degree of inflammation exceeds the compensatory range, its abnormally elevated level indicates uncontrolled inflammation, promoting myocardial fibrosis and remodeling. Conversely, the decreased apelin-13 levels weaken its protective effect on the vascular endothelium and its anti-fibrotic effect, leading to abnormal vascular tension, increased ventricular wall stress, and accelerated LVR progression.

[0080] The combined predictive results showed that the area under the curve (AUC) of multimodal ultrasound combined with serum sFRP5 and Apelin-13 in predicting post-PCI LVR in STEMI patients reached 0.905, significantly higher than that of a single indicator, with a sensitivity of 92.16% and a specificity of 88.29%. Combined prediction comprehensively covers the pathophysiological aspects of LVR from different dimensions: multimodal ultrasound, through transthoracic echocardiography (TTE), 2D-STI, and lung ultrasound, directly assesses cardiac structure and function (such as systolic function reflected in the GLS and pulmonary congestion reflected in the B-line integral); serum sFRP5 reflects the body's inflammatory state; and Apelin-13 reflects myocardial protective capacity. The combination of these indicators provides a comprehensive risk assessment encompassing structural function and molecular pathology. A single indicator can only cover one dimension, while combined detection achieves complementarity between structural function and molecular pathology, comprehensively capturing early signals of LVR, thus significantly improving predictive efficacy and providing a more accurate basis for early clinical identification of high-risk patients and the development of individualized intervention plans.

[0081] In conclusion, multimodal ultrasound (GLS intrinsic value and B-line integral) combined with serum sFRP5 and Apelin-13 levels has high predictive value for LVR after PCI in STEMI patients and has extremely high clinical application value.

[0082] The embodiments described above are merely preferred embodiments of the present invention and are not intended to limit the scope of the present invention. Various modifications and improvements made by those skilled in the art to the technical solutions of the present invention without departing from the spirit of the present invention should fall within the protection scope defined by the claims of the present invention.

Claims

1. A biomarker combination for predicting LVR after PCI in a STEMI patient, characterized in that, The biomarker combination comprises left ventricular endocardial subendocardial myocardial whole longitudinal strain value, pulmonary B-line score, serum sFRP5 and serum Apelin-13.

2. The biomarker combination of claim 1, wherein, The left ventricular endocardial subendocardial myocardial whole longitudinal strain value and the pulmonary B-line score are measured by multi-modal ultrasound technology.

3. The biomarker combination of claim 1, wherein, The left ventricular endocardial subendocardial myocardial whole longitudinal strain value and the pulmonary B-line score are measured within 1 week after PCI. The serum sFRP5 and serum Apelin-13 are measured within 24 hours before PCI.

4. Use of the biomarker combination of any one of claims 1-3 in the manufacture of a product for predicting LVR after PCI in a STEMI patient.

5. Use according to claim 4, characterized in that, The product comprises an instrument, a reagent or a kit.

6. A product for predicting LVR after PCI in a STEMI patient, characterized in that, The product comprises an instrument, a reagent or a kit for detecting left ventricular endocardial subendocardial myocardial whole longitudinal strain value, pulmonary B-line score, serum sFRP5 and serum Apelin-13.

7. Use of the biomarker combination of any one of claims 1-3 in the manufacture of a product for constructing a prediction model of LVR after PCI in a STEMI patient.

Images