基于心脏磁共振的层特异性菌株在免疫检查点抑制剂相关心肌炎中
Zheng Li1,2,3,4, Rui Zhao5, Cong Wang2,6
1Department of Echocardiography, Zhongshan Hospital, Fudan University, Shanghai, China.
ESC heart failure
|January 20, 2024
概括
皮质类固醇耐药性免疫检查点抑制剂相关心肌炎 (ICIaM) 显示出明显的心脏磁共振 (CMR) 成像特征. 全球纵向内心应变损伤 (GLSendo) 预测耐火ICIaM和较早的心血管事件.
科学领域:
- 心血管成像 - 心血管成像
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 免疫检查点抑制剂相关心肌炎 (ICIaM) 是一种严重的不良事件.
- 区分皮质类固醇敏感 (CS) 和皮质类固醇耐药 (CR) ICIaM对于管理至关重要.
- 心脏磁共振 (CMR) 可能会揭示CS和CR之间的截然不同的成像特征.
研究的目的:
- 为了比较CS和CR之间的CMR成像特征.
- 为了确定潜在的CMR参数,以便早期检测CR ICIaM.
主要方法:
- 对35名ICIaM患者和30名对照组的回顾性分析.
- 与对比的CMR,评估左心室喷射率 (LVEF) 和晚期加多增强 (LGE).
- 使用特征追踪量化全球纵向干系内心 (GLSendo) 和副心脏 (GLSepi) 的量化.
主要成果:
- 与CS ICIaM和对照组相比,CR ICIaM显示LVEF下降.
- 在CR ICIaM和CS ICIaM中,GLSendo和GLSepi都显著受损.
- 损伤GLSendo (≥-17.10%) 预测CR ICIaM具有高灵敏度和特异性 (86.7%和80.0%),并且是一个独立的预测因子.
结论:
- CS和CR ICIaM在CMR上表现出不同的功能和形态特征.
- 损伤的GLSendo是早期识别CR ICIaM的一个有价值的参数.
- 损坏的GLSendo预测了ICIaM患者早期的心血管不良事件.
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