摘要
目的探究心脏磁共振延迟强化(cardiac magnetic resonance-late gadolinium enhancement,CMR-LGE)对终末期肥厚型心肌病(end-stage phase of hypertrophic cardiomyopathy,ES-HCM)预后的评估价值。材料与方法前瞻性选择2015年8月至2019年11月在我院确诊并行CMR检查的103例ES-HCM患者,根据有无LGE分为LGE阴性组(n=26)与LGE阳性组(n=77),比较两组患者的临床症状体征、CMR参数及随访期间主要不良心血管事件(major adverse cardiovascular events,MACE)发生率。结果 LGE阳性组心悸、胸闷、胸痛、呼吸困难、下肢水肿、晕厥、心脏杂音、心率失常比例较LGE阴性组差异无统计学意义(P=0.873、0.570、0.916、0.872、0.805、0.981、0.598、0.975);LGE阳性组舒张末期左室壁最大厚度(left ventricular maximum wall thickness,LVMWT)显著高于LGE阴性组(P=0.000);LGE阳性组左室射血分数(left ventricular ejection fraction,LVEF)显著低于LGE阴性组(P=0.000);LGE阳性组左室收缩末期容积(left ventricular end systolic volume,LVESV)、右室射血分数(right ventricular ejection fraction,RVEF)、左室每搏搏出量(left ventricular stroke volume,LVSV)、左室舒张末期容积(left ventricular end diastolic volume,LVEDV)、右室每搏搏出量(right ventricular stroke volume,RVSV)、右室舒张末期容积(right ventricular end diastolic volume,RVEDV)、左心室心肌质量(left ventricular myocardial mass,LVMM)、右室收缩末期容积(right ventricular end systolic volume,RVESV)较LGE阴性组差异无统计学意义(P=0.874、0.869、0.929、0.949、0.853、0.918、0.986、0.818);LGE阳性组随访期间MACE发生率显著高于LGE阴性组(P=0.049)。结论 CMR-LGE在终末期肥厚型心肌病预后评估中有一定价值。
Objective:To investigate the prognostic value of cardiac magnetic resonancelate gadolinium enhancement(CMR-LGE)in patients with end-stage hypertrophic cardiomyopathy(ES-HCM).Materials and Methods:One hundred and three patients with ES-HCM in our hospital from August 2015 to November 2019 were enrolled,and divided into two groups according to the absence or presence of LGE,LGE-negative group(n=26)and LGE-positive group(n=77).The clinical symptoms and signs,CMR parameters,and the incidence of major adverse cardiovascular events(MACE)were compared between the two groups.Results:The proportion of palpitations,chest tightness,chest pain,dyspnea,lower extremity edema,syncope,cardiac murmur,and arrhythmia in the LGE-positive group had no significant difference with that of the LGE-negative group(P=0.873,0.570,0.916,0.872,0.805,0.981,0.598,0.975).The left ventricular maximum wall thickness(LVMWT)in the LGE-positive group was significantly higher than that in the LGE-negative group(P=0.000);the left ventricular ejection fraction(LVEF)in the LGE-positive group was significantly lower than that in the LGE-negative group(P=0.000);Left ventricular end-systolic volume(LVESV),right ventricular ejection fraction(RVEF),left ventricular stroke volume(LVSV),left ventricular end-diastolic volume(LVEDV),right ventricular stroke volume(RVSV),right ventricular end-diastolic volume(RVEDV),left ventricular myocardial mass(LVMM),and right ventricular end-systolic volume(RVESV)had no significant difference between groups(P=0.874,0.869,0.929,0.949,0.853,0.918,0.986,0.818).During the follow-up period,the incidence of MACE in the LGE-positive group was significantly higher than that in the LGEnegative group(P=0.049).Conclusions:CMR-LGE has certain clinical value in the prognosis assessment of end-stage hypertrophic cardiomyopathy.
作者
李林
姜严严
郭生鹏
LI Lin;JIANG Yanyan;GUO Shengpeng(Department of Radiology,Wuhan Asia General Hospital,Wuhan 430000,China)
出处
《磁共振成像》
CAS
2020年第10期911-914,共4页
Chinese Journal of Magnetic Resonance Imaging
关键词
心脏磁共振
延迟强化
肥厚型心肌病
预后评估
磁共振成像
cardiac magnetic resonance
late gadolinium enhancement
hypertrophic cardiomyopathy
prognosis assessment
magnetic resonance imaging
