在扩张性心肌病中,右心室内肌肉活检可以预先预测左心室纤维化吗?
Kisaki Amemiya1,2, Taka-Aki Matsuyama2, Hatsue Ishibashi-Ueda1,3
1Department of Pathology, National Cerebral and Cardiovascular Center, Osaka, Japan.
ESC heart failure
|January 18, 2024
概括
右心室内心肌内膜活检 (RV-EMB) 可以预测扩张性心肌病 (DCM) 中的左心室 (LV) 纤维化. 这一发现有助于使用可访问的活检方法评估DCM预后.
科学领域:
- 心脏病学 心脏病学
- 心脏病理学心脏病理学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 左心室 (LV) 心肌纤维化是扩张性心肌病 (DCM) 的关键预后指标.
- 精确评估LV纤维化对于管理DCM患者至关重要.
研究的目的:
- 确定右心室内心肌内膜活检 (RV-EMB) 纤维化是否可以预测DCM患者的LV纤维化程度.
- 评估RV-EMB纤维化和切割心脏中的LV纤维化之间的相关性.
主要方法:
- 在70个RV-EMB标本中比较纤维化程度,与DCM患者的52个心脏和18个尸体解剖心脏中的LV纤维化.
- 利用图像分析来量化活检和切除心脏中的纤维化面积比.
- 评估了心血管磁共振晚期加多增强剂 (LGE) 在心室内隔膜中的分布.
主要成果:
- 在RV-EMB和LV切割心脏中的纤维化面积比率之间发现了显著的正相关性 (r=0.82,P<0.0001).
- RV-EMB纤维化也与分散的LGE模式有显著的相关性 (r=0.71,P=0.003).
- 多变量分析证实RV-EMB纤维化预测LV纤维化,即使在调整了活检和切除之间的时间.
结论:
- 在RV-EMB中发现的纤维化与DCM中LV纤维化程度有很强的相关性.
- RV-EMB作为预测LV纤维化的一个有价值的工具,这是DCM的关键预后因素.
- 这种可访问的活检技术可以改善扩张性心肌病的预后评估.
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