心脏磁共振钆延迟强化程度与慢性心力衰竭患者预后的关系

摘要

Objective:To investigate the relationship between the amount of late gadolinium enhancement in cardiac magneticresonance (CMR) and the prognosis of patients with chronic heart failure.Methods:The patients with chronic heart failure admitted to heart failure department of the Beijing Anzhen Hospital during January 2015 to December 2016 were enrolled in this study.Cardiac magnetic resonance was performed to determine whether late gadolinium enhancement was present.And late gadolinium enhancement amount was also been evaluated by ％ Myo (LGE positive volume/Total myocardium volume * 100％).At the same time,baseline data,blood biochemical indexes and coronary angiography outcome were recorded.The patients were followed up regularly by telephone and outpatient department.The major adverse cardiovascular events were recorded,including cardiac death and heart transplantation.Results:84 end-stage heart failure patients were enrolled this study.After 2 years of follow-up,12 of the patients had cardiac death and 2 had heart transplants.There was no significant difference in the presence of late gadolinium enhancement in the event group and non-event group.Univariate and multivariate cox regression analysis showed that late gadolinium enhancement amount on 6SD threshold may independently associate with prognosis in patients with chronic heart failure (OR =1.049,95％ CI:1.019-1.079,P ＜ 0.001).Conclusion:Late gadolinium enhancement on 6SD threshold may be an independent predictor of prognosis in patients with chronic heart failure.%目的:探讨心脏磁共振中钆延迟强化程度与慢性心力衰竭患者预后的关系.方法:收集2015年1月至2016年12月,就诊于首都医科大学附属北京安贞医院慢性心力衰竭患者,行心脏磁共振检查,记录钆延迟强化是否出现,钆延迟强化程度的相关变量:钆延迟强化的异常心肌容量占总的心肌容量的百分比.同时记录两组患者的基线资料、血生化指标及冠状动脉造影术情况,通过电话及门诊对患者进行定期随访,记录主要不良心血管事件,包括心源性死亡、心脏移植.结果:经过2年的随访,其中12例患者发生心源性死亡,2例患者发生心脏移植.钆延迟强化的出现在事件组与非事件组中并无明显差异.单因素及多因素Cox回归分析发现,钆延迟强化程度可能是慢性心力衰竭患者预后的独立预测因子(OR=1.049,95％ CI:1.019～ 1.079,P＜0.001).结论:钆延迟强化程度可能是慢性心力衰竭患者预后的独立预测因子.