心脏磁共振评价肥厚型心肌病并发心房颤动的危险因素  

Risk factor analysis of hypertrophic cardiomyopathy with atrial fibrillation based on cardiac magnetic resonance

作　　者：田江雨 郭凌娟 杨丹丹 高靳[1] 赵正凯 梁勇[1] TIAN Jiangyu;GUO Lingjuan;YANG Dandan;GAO Jin;ZHAO Zhengkai;LIANG Yong(Departemt of Radiology,The Third People’s Hospital of Chengdu,Chengdu 610000,China;Department of Ultrasonography,The Third People’sHospital of Chengdu,Chengdu 610000,China)

机构地区：[1]成都市第三人民医院放射科,成都610000 [2]成都市第三人民医院超声科,成都610000

出　　处：《中国医科大学学报》2025年第1期44-50,共7页Journal of China Medical University

基　　金：四川省医学会(恒瑞)科研基金(2021HR53)。

摘　　要：目的基于心脏磁共振(CMR)分析探讨肥厚型心肌病(HCM)并发心房颤动(AF)的独立危险因素。方法回顾分析2022年1月至2023年12月我院80例HCM患者的病历资料,通过单因素分析得出HCM并发AF的危险因素,通过受试者操作特征曲线得出HCM并发AF的截断值,进一步通过二元logistic回归分析得出HCM并发AF的独立危险因素。结果单因素分析结果显示,左心室壁延迟强化(LGE)类型、无LGE左心室心肌初始T1 mapping值、左心房前后径、左心室LGE心肌节段数及前间隔基底段、前间隔中间段、下间隔中段LGE在HCM并发AF或不并发AF中差异有统计学意义(P<0.05)。多因素分析结果显示,左心室心内膜下LGE(P=0.048,OR=5.3,95%CI:0.642~43.311)、无LGE左心室心肌初始T1 mapping值≥1247 ms(P=0.03,OR=5.7,95%CI:0.734~27.41)、左心房前后径≥50 mm(P=0.013,OR=6.9,95%CI:1.489~31.538)在HCM并发AF或不并发AF中差异有统计学意义。结论左心室心内膜下LGE、无LGE左心室心肌初始T1 mapping值≥1247 ms、左心房前后径≥50 mm是HCM并发AF的独立危险因素。Objective To investigate the independent risk factors for hypertrophic cardiomyopathy(HCM)with atrial fibrillation(AF)based on cardiac magnetic resonance(CMR)using logistic regression analysis.Methods We reviewed 80 patients diagnosed with HCM at our hospital between January 2022 and December 2023.Statistical differences in the CMR and clinical parameters between patients with HCM with and without AF were compared.The cut-off value of HCM with AF was obtained by receiver operator characteristic curve,and binary logistic regression analysis was performed on statistically significant variables to identify independent risk factors for HCM in patients with AF.Results Univariate analysis showed that there were significant differences in the type of left ventricular late gadolinium enhancement(LGE),native T1 mapping value of the left ventricular myocardium without LGE,left atrial anteroposterior diameter,number of left ventricular LGE myocardial segments,and LGE in the basal anterior interventricular septum,mid anterior interventricular septum,and mid inferior interventricular septum were between HCM with and without AF(P<0.05).Multivariate analysis revealed that there were significant differences in left ventricular subendocardial LGE(P=0.048,OR=5.3,95%CI:0.642-43.311),native T1 mapping value of left ventricular myocardium without LGE≥1247 ms(P=0.03,OR=5.7,95%CI:0.734-27.41),and left atrium anteroposterior diameter≥50 mm(P=0.013,OR=6.9,95%CI:1.489-31.538)between HCM with and without AF.Conclusion Left ventricular subendocardial LGE,native T1 mapping value≥1247 ms,and left atrium anteroposterior diameter≥50 mm are independent risk factors for HCM with AF.

关 键 词：肥厚型心肌病 心房颤动 心脏磁共振 延迟强化 初始T1 mapping 

分 类 号：R541[医药卫生—心血管疾病]