在全身性硬化症中左心室肌肉的特征
Briella K Egberts1,2,3, Rajiv Ananthakrishna1,2,3,4,5, Ranjit Shah1,2,3
1College of Medicine and Public Health, Flinders University, Bedford Park 5042, Australia.
Journal of clinical medicine
|August 28, 2025
概括
没有心脏病的全身性硬化患者表现出亚临床左心室缺血和对压力的氧化反应受损. 这表明早期冠状动脉微血管功能障碍和纤维化有助于心血管风险.
科学领域:
- 心脏病学
- 放射学
- 关节病学
背景情况:
- 在全身性硬化 (SSc) 中心脏参与很常见,但左心室 (LV) 缺血机制尚不清楚.
- 肺动脉高血压 (PAH) 已被确认,但需要进一步调查.
- 氧气敏感心血管磁共振 (OS-CMR) 为心肌氧化和缺血提供了新的见解.
研究的目的:
- 在没有已知的心脏疾病的SSc患者中使用LVOS-CMR评估心肌脱氧变化.
- 使用先进的CMR技术评估SSc中的亚临床心脏参与.
- 在SSc中调查早期冠状动脉微血管功能障碍和LV心肌纤维化.
主要方法:
- 预期招募SSc患者和年龄/性别匹配的健康志愿者 (HV).
- 综合性心血管磁共振 (CMR) 包括原生T1映射,休息/压力OS-CMR,压力输液和晚期加多增强 (LGE).
- 通过胸腔回声扫描 (TTE) 来评估心脏功能.
主要成果:
- 与HV患者相比,SSc患者的全球LVOS- CMR信号强度显著降低 (p=0. 011).
- 在SSc患者中,至少有一部分患者表现出心肌氧化反应受损 (OS- CMR SI变化≤10%).
- 在SSc患者中观察到减少的LV全球纵向应变 (p=0. 045) 和扩散性纤维化 (T1映射异常78%) 的证据.
结论:
- 没有已知的心血管疾病或PAH的SSc患者表现出亚临床LV缺血和压力诱导的心肌氧化受损.
- 与对照组相比,SSc患者存在LV心肌变形异常和扩散纤维化.
- 结果表明早期冠状动脉微血管功能障碍和LV纤维化有助于SSc的心血管风险,独立于PAH.
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