在心磁共振成像中验证正常参考范围:动脉样硬化的多民族研究
Nadine Kawel-Boehm1, Spencer L Hansen2, Bharath Ambale-Venkatesh3
1Department of Radiology, Kantonsspital Graubuenden, Chur, Switzerland.
概括
对心磁共振 (CMR) 左心室参数的正常参考范围对于预测心血管事件具有临床意义. 然而,右心室参数和左心室终端透气直径与心血管风险无关.
科学领域:
- 心血管成像
- 医疗参考标准
- 心脏病学中的预测分析
背景情况:
- 心血管成像中的标准参考范围,通常使用2SD方法,缺乏先前验证.
- 心脏磁共振 (CMR) 广泛使用这些参考范围,因此需要对其临床预测有效性的评估.
研究的目的:
- 通过心磁共振成像 (CMR) 来确定正常参考值的临床预测效用.
- 使用纵向数据评估已确定的CMR参考范围与未来心血管事件的相关性.
主要方法:
- 在MESA研究中,从1518名健康参与者中确定了LV和RVCMR参数的参考范围.
- 考克斯的比例危险模型分析了4915名参与者的参考值与主要心血管不良事件 (MACE) 和所有心血管事件 (ACE) 之间的关系.
主要成果:
- 在男性和女性中,左心室末端透缩体积,末端抽缩体积和射出分数超过2 SD- 预测MACE和ACE.
- 与心血管事件相关的左心室质量和终端腹壁厚度,并观察到性别特异性.
- 左心室终端透气直径,右心室质量,右心室终端静脉体积和右心室喷射分数与心血管事件无关.
结论:
- 左心室CMR参数的正常参考范围对于预测心血管风险具有临床意义.
- 大多数左心室CMR参数低于2SD值,与5年和10年的心血管风险增加有关.
- 某些参数,包括左心室终端透气直径和右心室指标,没有显示出心血管事件的预测价值.
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