摘要
目的 探讨肥厚型心肌病延迟增强磁共振成像（MRI）显示的心肌纤维化与心律失常的相关性.方法 对48例未经治疗的肥厚型心肌病患者进行了MRI心功能分析、钆喷替酸葡甲胺（Gd-DTPA）延迟增强MRI、常规心电图和24 b动态心电图检查.分别探讨延迟增强MRI与频发室性期前收缩（PVCS总数≥200个）、阵发性室上性心动过速（SVT）、非持续性室性心动速（NSVT）、房室传导阻滞（AVB）、室内传导阻滞（IVB）之间的关系.计算延迟强化心肌质量、延迟强化心肌质量百分比,并分析其与24 h内PVCS、SVT和NSVT总数,传导阻滞（PR间期、QRS时限）间的相关性.描述肥厚型心肌病延迟强化节段的分布和特征.结果 48例肥厚型心肌病患者中35例出现延迟强化.出现PVCS、SVT、NSVT、AVB、IVB等心律失常的肥厚型心肌病患者中,延迟增强阳性患者出现PVCS、SVT、NSVT的数目显著大于延迟增强阴性患者（P=0.001～0.03）.延迟强化心肌质量百分比与QRS时限呈正相关（r=0.33,P＜0.001）.结论 延迟增强MRI显示的心肌纤维化与心律失常相关,可能为存在（或潜在）并发心律失常的肥厚型心肌病患者提供更多评估病情和预后的信息.
Objective To observe the association between myocardial fibrosis,detected by delayedenhancement（DE） cardiac magnetic resonance imaging （MRI） and arrhythmia in patients with hypertrophic cardiomyopathy （HCM）. Methods Forty-eight untreated HCM patients who underwent Cine MR, DE-MRI,24 h ambulatory Holter electrocardiogram and ECG examinations were recruited. Extent of myocardial fibrosis （fibrosis mass/total LV mass） was assessed using DE imaging. Association between arrhythmias including premature ventricular complexes （ PVCS ≥ 200 ）, supra-ventricular tachycardia （ SVT ）, non-sustained ventricular tachycardia （NSVT）, atrio-ventricular block （AVB） and intra-ventricular block （IVB） detected by Holter monitoring and ECG with regard to delayed enhancement （DE） on contrast enhanced CMR was analyzed. Results Myocardial fibrosis was detected in 35 patients. Incidence of arrhythmia was significantly higher in patients with DE than in patients without DE （ P 〈 0. 05 ）. Extent of myocardial fibrosis was significantly associated with the QRS duration （ r = 0. 33, P 〈 0. 001 ）. Conclusion Myocardial fibrosis detected by DE-CMR was associated with arrhythmia in patients with HCM. DE-CMR might be helpful to detect high-risk HCM patients prone to arrhythmia.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2010年第9期775-780,共6页
Chinese Journal of Cardiology
关键词
心肌病
肥厚性
磁共振成像
心律失常
Cardiomyopathy,hypertrophic
Magnetic resonance imaging
Arrhythmia
