不同室间隔形态肺高血压患者的心室功能特点:CMR初步研究

摘要

Background and objective To study the characteristics of ventricular function in Pulmonary Hy-pertension (PH) Patients with different shape of Interventricular Septum (IVS) by cardiac magnetic resonance (CMR). Methods 36 PH patients diagnosed by right heart catheterization accepted CMR. According to the morphology of IVS, the patients were divided into two groups: the non-deformation group (10 patients) and the deformation group (26 pa-tients). The ventricular function parameters were as follows: RV and LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume index (SVI), cardiac index (CI), ejection fraction (EF), and myocardial mass index (MMI).Results ANOVA analysis showed that the differences of RVEDVI,RVESVI,RVSVI,RVCI,RVEF,RVMMI, LVEDVI, LVESVI, LVSVI and LVCI were significant among the three groups. Compared with control group, RVSVI (P=0.017), RVEF (P<0.001), LVEDVI (P=0.048) and LVSVI (P=0.015) decreased in IVS non-deformation group. Compared with IVS non-deformation group, RVEDVI (P<0.001), RVESVI (P<0.001), RVCI (P=0.002) and RVMMI (P=0.017) were increased in IVS deformation group; while RVEF (P=0.001), LVEDVI (P=0.003), LVSVI (P<0.001)and LVCI (P=0.029) were decreased. Compared with the control group, RVEDVI (P<0.001), RVESVI (P<0.001), RVCI (P=0.004) and RVMMI (P=0.003) were increased in the IVS deformation group, while RVEF (P<0.001), LVEDVI (P<0.001), LVESVI (P<0.001), LVSVI (P<0.001), LVCI (P<0.001) were decreased. Conclusion Ventricular function is different in PH Patients with different IVS shape. The IVS shape can represent the changes of ventricular function in PH patients.%背景与目的 通过心脏磁共振(cardiovascular magnetic resonance, CMR)分析室间隔(interventricular septum, IVS)有无形变的肺高血压(pulmonary hypertension, PH)患者心功能特点.方法 经右心导管确诊为PH并接受CMR患者36例.根据IVS形态,分为无形变组(10例)和有形变组(26例);并与22例健康志愿者比较,参数如下:右心室(right ventricle, RV)和左心室(left ventricle, LV)舒张末期容积指数(end-diastolic volume index, EDVI)、收缩末期容积指数(end-systolic volume index, ESVI)、每搏输出量指数(stroke volume index, SVI)、心指数(cardiac index,CI)、射血分数(ejection fraction,EF)、心肌质量指数(myocardial mass index,MMI).结果 ANOVA分析示,RVEDVI、RVESVI、RVSVI、RVCI、RVEF、RVMMI、LVEDVI、LVESVI、LVSVI及LVCI在三组间差别均有统计学意义.事后组间结果比较显示,PH患者IVS无形变组与对照组相比,RVSVI(P=0.017)、RVEF(P<0.001)、LVEDVI(P=0.048)、LVSVI(P=0.015)均减低.IVS有形变组与IVS无形变组相比,RVEDVI(P<0.001)、RVESVI (P<0.001)、RVCI(P=0.002)、RVMMI(P=0.017)均升高;而RVEF(P=0.001)、LVEDVI(P=0.003)、LVSVI (P<0.001)及LVCI(P=0.029)减低.IVS有形变组与对照组相比,RVEDVI(P<0.001)、RVESVI(P<0.001)、RVCI (P=0.004)、RVMMI(P=0.003)均升高;而RVEF(P<0.001)、LVEDVI(P<0.001)、LVESVI(P<0.001)、LVSVI (P<0.001)、LVCI(P<0.001)均低于对照组.结论 不同IVS形态的PH患者,心室功能各有特点,IVS的形变在一定程度上能够反映PH患者心室功能的变化.