摘要
目的分析心脏磁共振检查延迟强化成像(LGE)对扩张型心肌病(DCM)患者的预后评价,并分析影响预后的危险因素。方法纳入2015年10月-2018年4月首都医科大学附属北京安贞医院收治的扩张型心肌病(DCM)患者58例,根据心脏磁共振检查LGE结果,分为LGE阳性组36例和LGE阴性组22例。分析2组患者的临床资料、心脏磁共振检查心功能指标、LGE等资料。随访12个月,记录不良心血管事件发生情况,进行单因素和多因素Logistic回归评估影响不良心血管事件的危险因素。结果与LGE阴性组比较,LGE阳性组患者的左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左心室心肌质量(LVM)及右心室心肌质量(RVM)明显增大(t=6.000、2.544、4.811、4.977,P<0.01);左室射血分数(LVEF)、每搏输出量(SV)及心输出量(CO)显著减小(t=7.323、4.354、2.134、P<0.05)。平均随访(12.5±2.2)个月,LGE阳性组不良心血管事件发生率明显高于LGE阴性组(61.1%vs.31.2%,χ^2=4.687,P=0.030),但2组的全因病死率和心源性病死率比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,年龄、LVEF、LGE和NT-proBNP是影响不良心血管事件的危险因素(均P<0.05)。结论LGE阳性的DCM心功能差,预后不良,LGE是不良预后的危险因素,可用于判断预后。
Objective To evaluate the characteristics and prognosis in patients with dilated cardiomyopathy(DCM)complicated with late gadolinium enhancement(LGE)in cardiac magnetic resonance imaging(cMRI)and risk factors for prognosis.Methods Rretrospectively analyzed data from 58 patients with DCM in Beijing Anzhen Hospital,from October 2015 to April 2018.Based on the presence of LGE in cMRI,36 patients were divided into the LGE group and 22 were in the control group.Clinical characteristics and prognosis were compared between the LGE group and control group.Risk factors for adverse cardiac events were analyzed by logistic regression analysis.Results Patients in the LGE group were associated with significantly larger LVEDD,LVESD,LVM and RVM(t=6.000,2.544,4.811,4.977,P<0.01)and lower left ventricular ejection fraction,stroke volume and cardiac output(t=7.323,4.354,2.134,P<0.05)compared with those in the control group.During the follow-up(12.5±3.2)months,the rates of adverse cardiovascular events was significantly higher in the LGE group compared with the control group(61.1%vs.31.2%,χ^2=4.687,P=0.030).Multi-Logistic regression analysis showed that advanced age,low LVEF,LGE and NT-proBNP were risk factors for adverse cardiac events(all P<0.05).Conclusion Patients with DCM complicated with LGE often have an increased level of cardiac enzymes,decreased cardiac function,and poor prognosis.LGE is the risk factor for prognosis.Therefore,LGE could be used as a tool for risk assessment in patients with DCM.
作者
张臣
赵蕾
马晓海
田洁
赵轶轲
徐磊
ZHANG Chen;ZHAO Lei;MA Xiaohai;TIAN Jie;ZHAO Yike;XU Lei(Department of Radiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)
出处
《疑难病杂志》
CAS
2019年第7期652-656,共5页
Chinese Journal of Difficult and Complicated Cases
基金
国家自然科学基金资助项目(81671647、81771787)
北京市自然科学基金(7172069)
院长基金(联合培育项目)(PX20170605)
关键词
扩张型心肌病
心脏磁共振
延迟强化成像
预后
危险因素
Dilated cardiomyopathy
Cardiac magnetic resonance imaging
Late gadolinium enhancement
Prognosis
Risk assessment
