扩张型心肌病患者血浆容量与心肌纤维化的相关性  

The correlation between plasma volume and myocardial fibrosis in patients with dilated cardiomyopathy

作　　者：朱洪炎 廖深根 张海锋 徐怡 姚文明 李新立 ZHU Hongyan;LIAO Shengen;ZHANG Haifeng;XU Yi;YAO Wenming;LI Xinli(Department of Cardiovascular Surgery,the First Affiliated Hospital with Nanjing Medical University,Nanjing,210029,China;Department of Cardiology,the First Affiliated Hospital with Nanjing Medical University;Department of Radiology,the First Affiliated Hospital with Nanjing Medical University)

机构地区：[1]南京医科大学第一附属医院,江苏省人民医院心脏大血管外科,南京210029 [2]南京医科大学第一附属医院,江苏省人民医院心血管内科,络病理论创新转化全国重点实验室 [3]南京医科大学第一附属医院,江苏省人民医院放射科

出　　处：《临床心血管病杂志》2024年第11期914-917,共4页Journal of Clinical Cardiology

摘　　要：目的:探讨扩张型心肌病(DCM)患者血浆容量负荷与心肌纤维化的相关性。方法:回顾性分析2018年3月—2020年9月于我院就诊并行心脏磁共振检查的113例DCM患者的临床资料。采用估计的全身血浆容量(PV)评估患者的容量负荷状态,根据PV中位数将患者分为高容量负荷组(56例)和正常容量负荷组(57例)。依据左心室中部室间隔初始T1值评估心肌纤维化情况。通过单因素和多因素分析及限制性立方样条模型分析DCM患者PV与心肌纤维化的相关性。结果:与正常容量负荷组相比,高容量负荷组纤维化程度更重[初始T1:(1 310±62.2) ms vs (1 350±69.8) ms,P=0.003]。限制性立方样条回归模型显示,PV与室间隔初始T1值呈线性正相关性。多因素线性回归分析校正传统的容量负荷生物标记物脑钠肽前体(proBNP)和BMI后,高容量负荷与初始T1值呈正相关性(β=30.61,95%CI:7.48~53.73,P=0.009)。结论:校正传统的血容量负荷生物标志物后,容量负荷状态与DCM患者心肌纤维化程度呈线性正相关。Objective:To explore the correlation between plasma volume overload and myocardial fibrosis in patients with dilated cardiomyopathy(DCM).Methods:A retrospective analysis was performed on 113 patients with DCM who were diagnosed and hospitalized in our hospital and underwent cardiac magnetic resonance imaging from March 2018 to September 2020.The patients'volume status was assessed using estimated total plasma vol-ume(PV),and they were divided into a high-volume load group(n=56)and a normal-volume load group(n=57)based on the median PV.Myocardial fibrosis was assessed based on the initial T1 value of the left ventricular mid-septum.The correlation between PV and myocardial fibrosis in patients with DCM was analyzed by univariate and multivariate analysis,as well as a restricted cubic spline model.Results:The high volume load group had more fibrosis than the normal volume load group[initial T1:(1310±62.2)ms vs(1350±69.8)ms,P=O.oo3].The restricted cubic spline regression model showed that plasma volume was linearly and positively corre-lated with the initial Tl value of the septum.After correction for the traditional volume load biomarker brain na-triuretic peptide precursor,and body mass index,high plasma volume was positively associated with initial T1 value(β=30.61,95%CI:7.48-53.73,P=0.009).Conclusion:After correction for the traditional volume load biomarkers,the volume load status was still linearly and positively associated with myocardial fibrosis in patients with di-lated cardiomyopathy.

关 键 词：扩张型心肌病 容量负荷 评估 脑钠肽前体 心肌纤维化 

分 类 号：R542.2[医药卫生—心血管疾病]