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患有急性心肌炎的患者心肌参数映射的预后价值:回顾性研究

Yining Wang¹, Xuejing Duan², Leyi Zhu¹

¹Department of Magnetic Resonance Imaging, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.

Radiology. Cardiothoracic imaging

|February 6, 2025

概括

心脏MRI T1映射和细胞外体积分数 (ECV) 预测急性心肌炎患者的主要不良心血管事件 (MACE). 这些先进的成像技术提供了比传统的临床参数更好的预后价值.

科学领域:

心血管成像 - 心血管成像
心脏磁力共振成像 (MRI)
肌心炎研究肌心炎研究

背景情况:

急性心肌炎是导致心血管疾病的重要原因.
准确的预后评估对于治疗急性心肌炎患者至关重要.
传统的临床和成像参数可能无法完全捕捉长期风险.

研究的目的:

评估T1映射,细胞外体积分数 (ECV) 和T2映射在大量急性心肌炎患者队列中的预后能力.
确定这些心脏MRI参数是否可以预测主要心血管不良事件 (MACE).
评估这些先进的MRI技术与已确定的临床因素相结合时的增量预后价值.

主要方法:

对235名急性心肌炎患者进行回顾性分析,这些患者接受了心脏MRI (3.0 T).
主要终点定义为MACEs (心脏病死亡,心力衰竭住院治疗,移植,心室节律失常,复发性心肌炎).
单变量和多变量考克斯回归分析,通过哈雷尔C指数评估预后值.

主要成果:

在平均1637天的随访期间,MACE发生在19%的患者中.
在患有MACE的患者中观察到较高的全球原生T1,ECV和T2值 (T1和ECV的P<0.001,T2的P=0.03).
原生T1和ECV独立预测MACE发生 (HR分别为1.61和1.70).
结合本地T1或ECV,哈雷尔C指数分别从0.72提高到0.76或0.79.

结论:

心脏MRI衍生原生T1和ECV是急性心肌炎中MACEs的独立预测因素.
这些先进的成像参数在与传统的临床评估相加时,提供了显著的增量预后价值.
T1映射和ECV量化是急性心肌炎风险分层的有价值工具.

关键词:

一个心脏病患者的心脏病.心灵的心脏心脏的心脏心脏心脏炎症炎症是一种炎症.这就是为什么MRI是MRI.

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