在患有超性心肌病的患者中,右心室缩症的预后影响
Sun Hwa Hong1, Eun-Ah Park2, Soon Gu Kwak3
1Department of Radiology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Republic of Korea.
Korean journal of radiology
|October 13, 2025
概括
通过心磁共振成像 (CMR) 检测到的右心室缩 (RVH) 独立地预测了缩性心肌病 (HCM) 患者的不良事件. 将RVH添加到风险模型中可能会改善心力衰竭住院和复合事件的预测.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 医学诊断 医学诊断 医学诊断
背景情况:
- 增高性心肌病变 (HCM) 是一种遗传性心脏病.
- 在HCM中风险分层对于预防心脏突然死亡 (SCD) 和心力衰竭 (HF) 至关重要.
- 在HCM中右心室缩 (RVH) 的预后值需要进一步评估.
研究的目的:
- 用心磁共振成像 (CMR) 评估RVH在HCM患者的预后意义.
- 为了确定RVH是否改善已建立的5年突然心脏死亡风险预测模型.
主要方法:
- 对320名CMR和心声回应心脏病患者的回顾性研究 (2007-2019).
- RVH定义为右心室壁厚度≥5mm.
- 使用Kaplan-Meier,Cox回归和C指数分析来评估RVH的预后作用和对HF住院和复合不良事件的模型改进.
主要成果:
- 20.1%的患者患有RVH.
- RVH是HF住院 (HR=3.19) 和复合不良事件 (HR=2.38) 的独立预测因素.
- 纳入RVH显著改善了Harrell的C指数,无论是HF住院 (0.606到0.688,P=0.033) 还是复合事件 (0.641到0.727,P=0.030).
结论:
- 通过CMR检测到的RVH是HCM中不良结果的独立预测因素.
- RVH评估提高了HCM常规风险模型的预测性能.
- 在HCM评估中建议进行常规的双心脏评估.
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