| 薛润洁,高艳,王文先,朱润赜,杨祥琳,常娜,王锡明.基于心脏MR细胞外体积分数预测左心室致密化不全患者发生主要不良心血管事件[J].中国医学影像技术,2026,42(3):331~335 |
| 基于心脏MR细胞外体积分数预测左心室致密化不全患者发生主要不良心血管事件 |
| Extracellular volume fraction based on cardiac MR for predicting major adverse cardiovascular event in patients with left ventricular noncompaction |
| 投稿时间：2025-11-06 修订日期：2026-01-17 |
| DOI：10.13929/j.issn.1003-3289.2026.03.003 |
| 中文关键词: 左心室 孤立性心室心肌致密化不全 心脏磁共振 细胞外体积分数 预后 |
| 英文关键词:left ventricle isolated noncompaction of the ventricular myocardium cardiac magnetic resonance extracellular volume fraction prognosis |
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| 中文摘要: |
| 目的 观察基于心脏MR(CMR)细胞外体积分数(ECV)预测左心室致密化不全(LVNC)患者发生主要不良心[LM]血管事件(MACE)的价值。方法 回顾性收集118例LVNC,均接受规律随访至2025年6月30日,记录期间是否发生MACE。以单因素及多因素Cox回归分析临床资料及CMR参数,筛选MACE的独立预测因子;绘制受试者工作特征曲线,获取ECV预测LVNC患者发生MACE的最佳截断值,据此划分高ECV组与低ECV组,比较组间累积无MACE生存率差异,并基于有、无心肌钆对比剂延迟强化(LGE)进行分析。结果 中位随访时间33.5个月,期间27例发生MACE(MACE组)、91例未发生MACE(非MACE组)。CMR参数中,左心室射血分数、ECV及LGE心肌占左心室质量百分比均为MACE独立预测因子(HR=0.92、1.14、1.06,P均＜0.05)。ECV预测LVNC患者发生MACE的截断值为32.10,故将40例ECV≥32.10者归为高ECV组、78例ECV＜32.10为低ECV组。高ECV组累积无MACE生存率低于低ECV组;且无论LGE(+)或LGE(-)的高ECV者的累积无MACE生存率均低于低ECV者(P均＜0.05)。结论 基于CMR的ECV能有效预测LVNC患者发生MACE风险。 |
| 英文摘要: |
| Objective To observe the value of extracellular volume fraction (ECV) based on cardiac MR (CMR) for predicting major adverse cardiovascular event (MACE) in patients with left ventricular noncompaction (LVNC). Methods Totally 118 patients with LVNC were retrospectively enrolled who underwent regularly follow-up until June 30, 2025, and whether MACE occurred was recorded. Univariate and multivariate Cox regression analyses were performed on clinical data and CMR parameters to screen the independent predictors for occurrence of MACE. The optimal cutoff value of ECV for predicting the occurrence of MACE in LVNC patients was obtained through receiver operating characteristic curve, and then patients were divided into high-ECV and low-ECV groups based on it. The cumalative MACE-free survial rate was compared between groups, also those with or without myocardial late gadolinium enhancement (LGE). Results The median follow-up time was 33.5 months. During follow-up period, 27 cases experienced MACE (MACE group), while 91 cases did not (non-MACE group). Among CMR parameters, left ventricular ejection fraction, ECV and the percentage of LGE myocardium in left ventricular mass were all independent predictors of MACE (HR=0.92, 1.14, 1.06, all P＜0.05). The cutoff value of ECV for predicting MACE in LVNC patients was 32.10. There were 40 cases in high-ECV group and 78 cases in low-ECV group.The cumulative MACE-free survival rate in high-ECV group was lower than that in low-ECV group. Moreover, the cumulative MACE-free survival rate in patients with high ECV, no matter LGE (+) or LGE (-), was lower than in those with low ECV (all P＜0.05). Conclusion ECV based on CMR could effectively predict the risk of MACE in patients with LVNC. |
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