摘要
目的:探讨心脏磁共振对围生期心肌病不良心血管事件的预测价值,为早期识别高危患者提供依据。方法:回顾性纳入围生期心肌病且行增强心脏磁共振检查的患者,并进行随访。终点事件包括心源性死亡、心力衰竭再住院、心脏移植、危及生命的心律失常及肺栓塞或系统性栓塞。根据是否发生不良事件将患者分为事件组和无事件组。通过COX回归分析了解不良心血管事件的相关因素。结果:共纳入29例围生期心肌病患者,平均年龄33岁,9例患者在随访中发生不良心血管事件。两组患者的妊娠情况差异无统计学意义。有9例(31%)患者存在延迟强化(late gadolinium enhancement,LGE),事件组LGE阳性患者数量和LGE质量分数均高于无事件组。整体纵向应变(global longitudinal strain,GLS)和整体周向应变(global circumferential strain,GCS)在事件组降低更明显,GCS:[(-8.7±1.9)%vs.(-7.1±1.6)%,P=0.03];GLS:[(-7.7±2.1)%vs.(-5.9±1.4)%,P=0.02]。单因素Cox分析显示LVEF,LGE质量分数,GCS和GLS均与不良心血管事件相关(P均<0.05)。结论:LVEF、LGE、GCS和GLS与围生期心肌病患者不良心血管事件相关,心脏磁共振有望成为围生期心肌病患者危险分层的工具。
Objective:To investigate the predictive ability of cardiac magnetic resonance imaging(MRI)for adverse cardiovascular events in peripartum cardiomyopathy(PPCM),and to provide a basis for early identification of high-risk patients.Methods:Patients who were diagnosed as PPCM and underwent enhanced cardiac MRI were retrospectively enrolled.Patients were followed up via clinic or telephone.The primary endpoints were major adverse cardiovascular events,including cardiac related death,heart transplantation,hospitalization for heart failure,life-threatening arrhythmia,pulmonary embolism or systemic embolism.Patients were divided into event group or non-event group based on whether adverse events have occurred.COX regression analysis were used to investigate the association between MRI parameters and adverse events.Results:A total of 29 patients with PPCM were included,with an average age of 33 years.Nine patients had primary endpoints during the follow-up period.There was no statistically significant difference in pregnancy between the two groups.Nine(31%)patients were LGE positive,and LGE percent in the event group were higher than those in the non-event group(P=0.03).The global longitudinal strain(GLS)and global circumferential strain(GCS)decreased more significantly in the event group GCS:[(-8.7±1.9)%vs.(-7.1±1.6)%,P=0.03];GLS:[(-7.7±2.1)%vs.(-5.9±1.4)%,P=0.02].Univariate Cox analysis showed that LVEF,LGE percent,GCS and GLS were associated with adverse cardiovascular events.Conclusions:LVEF,LGE,GCS,and GLS are associated with adverse cardiovascular events.Cardiac magnetic resonance imaging is a potential tool for risk stratification in patients with PPCM.
作者
李爽
任玥
庄白燕
徐磊
LI Shuang;REN Yue;ZHUANG Baiyan;XU Lei(Department of Radiology,Beijing Anzhen Hospital,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Capital Medical University,Beijing 100029,China)
出处
《心肺血管病杂志》
CAS
2023年第10期1062-1066,共5页
Journal of Cardiovascular and Pulmonary Diseases
基金
国家重点研发计划(2022YFE0209800)
国家自然科学基金(U1908211,82271986)
首都医科大学临床专科学院(系)培养基金开放课题(CCMU2023ZKYXY014)。
关键词
围生期心肌病
心脏磁共振
不良心血管事件
Peripartum cardiomyopathy
Cardiac magnetic resonance
Adverse cardiovascular events
