心脏MRI特征评估心肌纤维化预测二尖瓣脱垂的临床研究  

Evaluation of Myocardial Fibrosis by Cardiac MRI in Patients with Mitral Valve Prolapse

作　　者：张晓宇[1] 庞孟春 周强 张涛[2] ZHANG Xiao-yu;PANG Meng-chun;ZHOU Qiang;ZHANG tao(Department of radiology,People's Hospital of Jianyang City,Chengdu 641400,Sichuan Province,China;Department of radiology,West China Hospital,Sichuan University,Chengdu 611530,Sichuan Province,China)

机构地区：[1]简阳市人民医院放射科,四川成都641400 [2]四川大学华西医院放射科,四川成都611530

出　　处：《中国CT和MRI杂志》2025年第2期124-126,共3页Chinese Journal of CT and MRI

基　　金：四川省自然科学基金(23NSFSC4096)。

摘　　要：目的无中重度二尖瓣反流或左室功能障碍的二尖瓣脱垂(MVP)患者的晚期钆增强心脏MRI二尖瓣环分离(MAD)和心肌纤维化的预后价值。方法回顾性分析2020年-2024年我院收治的80名心脏MRI患者的临床资料,所有患者平均随访3.3年。终点包括持续性室性心动过速(VT)、心源性猝死(SCD)或不明原因的晕厥,并进行多变量Cox回归分析。结果80名患者女性34名,平均年龄50岁±16岁。在中位3.3年的随访中,18名患者(4%)达到了研究终点。LGE存在(P=0.006)和程度(P=0.006)为终点影响因素,但与临床结果无关(P=0.89)。LGE的存在相对于MVP严重程度和基线时持续VT和流产SCD具有递增的预后价值(P=0.03)。结论与二尖瓣环分离相反,心脏MRI晚期钆增强检测的心肌纤维化与二尖瓣脱垂患者的不良结局相关,无中度至重度二尖瓣反流或左心室功能障碍。Objective To evaluate the prognostic value of late gadolinium enhanced cardiac MRI for mitral annular separation(MAD)and myocardial fibrosis in patients with mitral valve prolapse(MVP)without moderate or severe mitral regurgitation or left ventricular dysfunction.Methods the clinical data of 80 patients with cardiac MRI admitted to our hospital from January 2020 to December 2024 were retrospectively analyzed.All patients were followed up for an average of 3.3 years.Endpoints included sustained ventricular tachycardia(VT),sudden cardiac death(SCD),or unexplained syncope,and multivariate Cox regression analysis was performed.Results there were 34 females in the 80 patients,with an average age of 47±16 years.At a median follow-up of 3.3 years,18 patients(4%)reached the study endpoint.The presence(P=0.006)and extent(P=0.006)of LGE were the influencing factors of the endpoint,but they were not related to the clinical outcome(P=0.89).The presence of LGE had an increasing prognostic value relative to MVP severity and persistent VT and abortive SCD at baseline(P=0.03).Conclusion in contrast to mitral annular separation,myocardial fibrosis detected by late gadolinium enhancement on cardiac MRI is associated with adverse outcomes in patients with mitral valve prolapse,without moderate to severe mitral regurgitation or left ventricular dysfunction.

关 键 词：二尖瓣反流 二尖瓣脱垂 二尖瓣环分离 心脏MRI 

分 类 号：R542.51[医药卫生—心血管疾病]