左心室硬度识别了儿童具有磁共振成像证明的急性心肌炎,尽管保留了左心室缩功能
Ryusuke Numata1, Renzo Calderon-Anyosa2, Danish Vaiyani3
1Division of Cardiology, The Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, 3401 Civic Center Boulevard, Philadelphia, PA, 19104, USA. k054eb@gmail.com.
Pediatric cardiology
|November 6, 2025
概括
在患有急性心肌炎和保存的喷射分数的儿童中,左心房 (LA) 刚性升高,表明腹功能障碍. 这种新型标志物显示了儿科心肌炎的高诊断准确性.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 心血管成像 - 心血管成像
- 生物物理学的生物物理.
背景情况:
- 左心房 (LA) 在儿科心肌炎评估中经常被忽视.
- 在此之前,LA度已经显示出在COVID-19儿童中识别腹功能障碍和心肌损伤的潜力.
研究的目的:
- 为了调查LA硬度是否在被诊断为患有急性心肌炎的儿童中异常,这些儿童保存了喷射分数.
- 评估LA度在这个儿科群体中的诊断效用.
主要方法:
- 对51名患有急性心肌炎 (通过心脏MRI诊断) 的儿科患者和40名健康对照者的回顾性分析.
- 纳入标准:保存的左心室喷射分数 (LVEF>55%).
- 心声学 (2D和斑点跟踪) 评估了LV功能和LA应变;LA刚度计算为E/e'到峰值LA应变的比率.
主要成果:
- 与对照组相比,肌心炎患者的LA硬度显著增加 (0.27 ± 0.09 vs 0.15 ± 0.04 %−1,p < 0.001),并在随访时保持升高.
- 肌硬度与B型性尿素 (BNP) 峰值水平 (r = 0.66,p < 0.001) 的相关性最强.
- 在心声学指数中,LA度达到最高的诊断性能 (AUC 0.94),是独立预测指标 (OR 1.58). 综合得分与LV峰纵向应变产生了0.98.98的AUC.
结论:
- 升高的LA硬度是儿科急性心肌炎的显著发现,具有保存的LVEF,反映了扩张性损伤.
- 拉动脉硬度作为儿童急性心肌炎的有价值,独立的诊断标志物,截止值为0.20%-1提供增量诊断价值.
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