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Elena Rimskaya¹, Olga Aparina¹, Olga Stukalova¹

¹Chazov National Medical Research Center of Cardiology 121552, Academician Chazov str., 15a, Moscow, Russia.

Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology

|January 2, 2025

概括

在扩张性心肌病 (DCM) 患者中,左捆支部阻塞 (LBBB) 并不是由焦点或间歇性纤维化引起的. 扩散性炎症可能会恶化缩功能障碍,而异常性LBBB中的纤维化增加表明DCM正在发展.

科学领域:

心脏病学心脏病学
心脏成像 - - 心脏成像
病理学病理学病理学

背景情况:

左捆支部阻塞 (LBBB) 是扩张性心肌病 (DCM) 患者的常见发现.
核心基质和心脏纤维化和DCM中的LBBB之间的关系仍然不完全理解.
区分LBBB的原因对于预后和管理至关重要.

研究的目的:

调查DCM患者中焦点和扩散左心室 (LV) 纤维化和LBBB之间的关联.
为了比较DCM患者的纤维化模式,有和没有LBBB,以及那些具有异常性LBBB的患者.

主要方法:

用晚期加多增强 (LGE) 的心血管磁共振 (CMR) 来评估焦点纤维化 (核心痕和灰色区域) 和扩散纤维化 (扩散强度比 - DIR).
内心肌活检 (EMB) 在一组患者中量化了原体积分数 (CVF).
研究包括DCM患者LBBB (DCM-LBBB),DCM没有LBBB (DCM-非LBBB),异常LBBB和健康志愿者 (HV).

主要成果:

在DCM-LBBB和DCM-non-LBBB患者之间没有发现焦点或扩散纤维化的显著差异.
CVF与DIR相关,支持DIR作为扩散性纤维化症的衡量标准.
与HV相比,患有异常性LBBB的患者的DIR值较高,这表明底层的扩散性心肌变化.

结论:

焦点和间歇性纤维化与DCM中的LBBB无关.
在DCM-LBBB中扩散性炎症可能会导致心功能障碍,但不会导致LBBB.
在异常性LBBB中增加的间歇性纤维化可能表明导致DCM发展的潜在过程.

关键词:

心血管磁共振是一种心血管磁共振.扩展性心肌病变异症扩展性心肌病变异症内心肌组织活检内心肌组织活检晚期加多增强的加多增强左捆的分支区块的分支区块.

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