伴或不伴房颤的肥厚型心肌病患者左心结构与功能差异的MRI研究  

The study of left heart structure and function difference in hypertrophic cardiomyopathy patients with or without atrial fibrillation by MRI

作　　者：徐敏[1] 孙兆男 王旭超 徐畅[1] 王巍[1] XU Min;SUN Zhaonan;WANG Xuchao;XU Chang;WANG Wei(Department of Magnetic Resonance,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第一临床医学院磁共振科

出　　处：《磁共振成像》2019年第11期821-825,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的应用心脏磁共振探索伴或不伴房颤的肥厚型心肌病患者左心结构与功能差异,并为临床积极治疗提供依据。材料与方法回顾性分析在我院接受1.5 T心脏磁共振检查并确诊为肥厚型心肌病的109位患者,根据有无房颤发生,分为房颤组(21例)及非房颤组(88例),比较两组患者代表左心结构及功能的多个磁共振参数,将有统计学意义的左室参数进行多因素Logistic回归分析,得出发生房颤的相关影响因素。结果肥厚型心肌病合并房颤患者的左房前后径、年龄、钆对比剂延迟强化百分比高于无房颤的肥厚型心肌病患者(P<0.05),房颤患者的左室射血分数、左室峰值充盈率低于无房颤患者(P<0.05),其余参数没有显著差异(P>0.05)。在多因素Logistic回归分析中,肥厚型心肌病患者发生房颤与左室峰值充盈率(P=0.011)、钆对比剂延迟强化百分比(P=0.005)相关。结论肥厚型心肌病伴或不伴房颤患者的左室峰值充盈率、左室射血分数、年龄及左房前后径、钆对比剂延迟强化百分比存在差异。其中,左室峰值充盈率、钆对比剂延迟强化百分比为肥厚型心肌病患者发生房颤的影响因素。Objective: To explore the differences of left heart structure and function in hypertrophic cardiomyopathy patients with or without atrial fibrillation using cardiac magnetic resonance imaging, and provide a basis for clinical active treatment. Materials and Methods: Retrospective analysis of 109 hypertrophic cardiomyopathy patients who underwent 1.5 T cardiac magnetic resonance and were diagnosed in our hospital, according to the presence of atrial fibrillation, were divided into atrial fibrillation group(n=21) and non-atrial fibrillation group(n=88), comparing the two groups of patients with magnetic resonance parameters representing left heart structure and function, multivariate logistic regression analysis was performed on the left ventricle statistically significant parameters, to obtain the relevant influencing factors of atrial fibrillation. Results: LAAPD, age, LGE% in hypertrophic cardiomyopathy patients with atrial fibrillation was higher than hypertrophic cardiomyopathy patients without atrial fibrillation(P<0.05). LVEF and LVPFR in patients with atrial fibrillation was lower than patients without atrial fibrillation(P<0.05). The other parameters were no significant difference between the two groups(P>0.05). In multivariate logistic regression analysis, hypertrophic cardiomyopathy patients with atrial fibrillation was associated with LVPFR(P=0.011) and LGE%(P=0.005). Conclusions: The LVPFR and LVEF, age, LAAPD and LGE% are difference in hypertrophic cardiomyopathy patients with or without atrial fibrillation. Inside, LVPFR and LGE% were predictors of hypertrophic cardiomyopathy patients with AF.

关 键 词：心肌病 肥大性 心房颤动 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]