| 程赛楠,崔辰,李璐,尹刚,陈秀玉,陆敏杰,赵世华.终末期肥厚型心肌病的MRI特征及预后分析[J].中国医学影像技术,2017,33(4):539~544 |
| 终末期肥厚型心肌病的MRI特征及预后分析 |
| MRI characteristics and outcomes of end-stage hypertrophic cardiomyopathy |
| 投稿时间：2016-08-28 修订日期：2017-01-22 |
| DOI：10.13929/j.1003-3289.201608123 |
| 中文关键词: 心肌病,肥厚型 磁共振成像 |
| 英文关键词:Cardiomyopathy, hypertrophic Magnetic resonance imaging |
| 基金项目:国家自然科学基金（81620108015）、协和青年基金（3332016025）。 |
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| 中文摘要: |
| 目的 探讨终末期肥厚型心肌病（ES-HCM）患者MRI特征及预后。方法 回顾性收集我院接受MR检查的ES-HCM患者57例，根据心肌形态结构及运动功能，分为扩张性组（D-ES，n=39）及限制性组（R-ES，n=18），比较2组患者临床、MRI特征及预后。结果 R-ES组心房颤动及下肢水肿发生率明显高于D-ES组[72.22%（13/18）vs 30.77%（12/39）；50.00%（9/18）vs 23.08%（9/39）；P均<0.05]。D-ES组患者左心室射血分数、左右心房前后径显著小于R-ES组（P均<0.05），左心室舒张末内径、左心室舒张/收缩末容积、左心室舒张/收缩末容积指数显著大于R-ES组（P均<0.05）。Log-rank检验发现2组患者发生心源性死亡/心脏移植事件的差异无统计学意义（χ2=1.135，P=0.287）。但D-ES组对比剂延迟强化（LGE）体积分数显著高于R-ES组[（36.1±14.8）% vs （21.0±9.0）%，P<0.001]，且LGE体积分数与心源性死亡/心脏移植风险相关（HR：1.054，P<0.05）。结论 ES-HCM患者MRI特征呈多样性，不仅有扩张性失代偿改变，而且有限制性失代偿改变。MRI在该病的诊断和预后评估中有重要价值。 |
| 英文摘要: |
| Objective To clarify the MRI characteristics and outcomes of patients with end-stage hypertrophic cardiomyopathy (ES-HCM). Methods Clinical and MRI data of 57 ES-HCM patients were retrospectively analyzed. ES-HCM patients were divided into dilated phenotype group (D-ES group, n=39) and restrictive phenotype group (R-ES group, n=18). MRI characteristics and outcomes of patients were compared between both groups. Results The incidence of atrial fibrillation and edema of lower extremity was significantly higher in R-ES than those in D-ES (72.22% [13/18]vs 30.77%;[12/39] 50.00%[9/18] vs 23.08%; both P<0.05). The left ventricular ejection function, left and right atrial anteroposterior diameter of D-ES group were significant smaller than those of R-ES group (all P<0.05), while the left ventricular (LV) short axis diameter, LV end diastolic/systolic volume and LV end diastolic/systolic volume index of D-ES were significantly greater than those of R-ES group (all P<0.05). Log-rank test found no significant difference between both groups in cardiovascular death/heart transplant events (χ2=1.135, P=0.287). Late gadolinium enhancement (LGE) volume fraction was significantly larger in D-ES ([36.1±14.8]%) than in R-ES ([21.0±9.0]%; P<0.05). There was a significant correlation between LGE volume fraction and cardiovascular death/heart transplant events (HR:1.054, P<0.05). Conclusion ES-HCM patients have expanded clinical expression and MRI characteristics, including dilated phenotype and restrictive phenotype. MRI has an important application value in the diagnosis and prognosis evaluation of ES-HCM. |
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