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在多变性心肌病中微血管功能障碍的证据:来自多参数磁共振成像的新见解

Steffen E Petersen¹, Michael Jerosch-Herold, Lucy E Hudsmith

¹University of Oxford Centre for Clinical Magnetic Resonance Research, Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, OX3 9DU, UK. steffen.petersen@cardiov.ox.ac.uk

|April 25, 2007

概括

在多变性心肌病 (HCM) 中,减少血液流量储备与更大的心肌厚度和纤维化有关. 这种微血管功能障碍可能会增加HCM患者突然心脏死亡的风险.

科学领域:

心脏病学心脏病学
心血管成像 - 心血管成像
肌心输血是指肌心输血.

背景情况:

超性心肌病 (HCM) 中的微血管功能障碍可能导致心脏突然死亡.
在HCM中,心脏缩程度与输液储备受损之间的关系尚不清楚.
需要多参数成像来探索高, perfusion 和纤维化风险分层.

研究的目的:

在HCM患者中调查左心室缩程度与心肌输液储备之间的关联.
为了比较心肌动脉血流 (MBF) 和纤维化在HCM患者与健康对照.
为了确定过度缩的大小是否与减少的 perfusion 储备和增加的纤维化相关.

主要方法:

磁共振成像 (MRI) 用于评估缩,休息和高血压的心肌血流 (hMBF),以及35名HCM患者和14名对照者的纤维化.
使用了美国心脏协会的左心室16段模型.
经多个变量调整后的统计分析,包括终端透析壁厚.

主要成果:

与对照组相比,HCM患者的hMBF显著降低,而不依赖壁壁厚度.
在HCM患者中,hMBF随着末端透析壁厚度的增加而成比例下降,特别是在内心层.
增加壁壁厚度与内心hMBF下降到上心hMBF的频率更高以及心肌纤维化发生率更高相关.

结论:

超性心肌病症的特点是血管扩张反应减少,特别是在内心,这与超的程度成正比.
微血管功能障碍和由此产生的缺血可能是HCM突然心脏死亡风险的重要贡献者.
这些发现表明,多参数的MRI评估的缩,输液和纤维化可能会提高HCM的风险分层.

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