磁共振评价慢性心力衰竭患者右心结构及功能的临床研究
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摘要
目的研究心脏磁共振在慢性心力衰竭(CHF)右心结构及功能评价中的应用价值。方法选择2016年1月～2017年12月成都市第五人民医院收治的CHF患者32例作为观察组,另选择同期体检的健康者32名作为对照组。两组均行CMR检查,比较两组的右心结构及功能指标,包括右室侧壁厚度(RVT)、右室侧壁质量(RVM)、右室乳头肌质量(RVPM)、右室舒张末期容积(RVEDV)、右室收缩末期容积(RVESV)、右室每搏输出量(RVSV)、右室射血分数(RVEF)。结果观察组的右心室RVT、RVM、RVPM、RVEDV、RVESV和RVSV较对照组明显升高,RVEF较对照组明显降低,差异有统计学意义(P <0.05或P <0.01)。结论 CMR可定量分析CHF患者右心室结构和功能,有助于判断患者疾病进展情况。
Objective To study the value of cardiac magnetic resonance(CMR) in the evaluation of right heart structure and function in chronic heart failure. Methods From January 2016 to December 2017, in the Fifth People′s Hospital of Chengdu, 32 patients with CHF were chosen as observation group, another 32 healthy person who received physical examination at the same period were chosen as control group. CMR examination was performed in both groups, and the right heart structure and function indexes of two groups were compared, such as right ventricular thickness(RVT), right ventricular mass(RVM), right ventricular papillary muscle mass(RVPM), right ventricular end diastolic volume(RVEDV), right ventricular systolic volume(RVESV), right ventricular stroke volume(RVSV), right ventricular ejection fraction(RVEF). Results The RVT, RVM, RVPM, RVEDV, RVESV and RVSV of the right ventricle in the observation group were significantly higher than those in the control group, the RVEF was significantly lower than that in the control group, the differences were statistically significant(P < 0.05 or P < 0.01). Conclusion CMR can quantitatively analyze the right ventricular structure and function of patients with CHF, which helps to determine the patients′ disease progression.
Objective To study the value of cardiac magnetic resonance(CMR) in the evaluation of right heart structure and function in chronic heart failure. Methods From January 2016 to December 2017, in the Fifth People′s Hospital of Chengdu, 32 patients with CHF were chosen as observation group, another 32 healthy person who received physical examination at the same period were chosen as control group. CMR examination was performed in both groups, and the right heart structure and function indexes of two groups were compared, such as right ventricular thickness(RVT), right ventricular mass(RVM), right ventricular papillary muscle mass(RVPM), right ventricular end diastolic volume(RVEDV), right ventricular systolic volume(RVESV), right ventricular stroke volume(RVSV), right ventricular ejection fraction(RVEF). Results The RVT, RVM, RVPM, RVEDV, RVESV and RVSV of the right ventricle in the observation group were significantly higher than those in the control group, the RVEF was significantly lower than that in the control group, the differences were statistically significant(P < 0.05 or P < 0.01). Conclusion CMR can quantitatively analyze the right ventricular structure and function of patients with CHF, which helps to determine the patients′ disease progression.
引文
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[2]Awotidebe TO,Adeyeye V,Adedoyin RA,et al.Assessmen of functional capacity and sleep quality of patients with chronic heart failure[J].Hong Kong Physiotherapy J,2017,36(C):17-24.
[3]Fu R,Xiang X,Bao H,et al.Association between process indicators and in-hospital mortality among patients with chronic heart failure in China[J].Eur J Public Health,2014,25(3):373-378.
[4]Mordi IR,Singh S,Rudd A,et al.Comprehensive echocardiographic and cardiac magnetic resonance evaluation differentiates among heart failure with preserved ejection fraction patients,hypertensive patients,and healthy contro subjects[J].JACC:Cardiovascular Imaging,2018,11(4):577-585.
[5]Reynolds A,Zareba KM.Cardiac magnetic resonance imaging in heart failure[J].Encycl Cardio Res Med,2018:451-462.
[6]Su MY,Lin LY,Tseng YH,et al.CMR-verified diffuse myocardial fibrosis is associated with diastolic dysfunction in HFpEF[J].JACC Cardiovasc Imaging,2014,7(10):991-997.
[7]Kharin SN,Krandycheva VV,Tsvetkova AS,et al.Remodeling of ventricular repolarization in experimental right ventricular hypertrophy[J].J Electrocardiology,2017,50(5):626-633.
[8]秦牧,于胜波,孔斌,等.右心室舒张末期内径对慢性收缩性心力衰竭患者预后的影响[J].中华老年医学杂志,2015,34(8):849-853.
[9]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):98-122.
[10]Tadic M,Pieske-Kraigher E,Cuspidi C,et al.Right ventricular strain in heart failure:clinical perspective[J].Arch Cardiovas Dis,2017,110(10):562-571.
[11]Bristow MR,Kao DP,Breathett KK,et al.Structural and functional phenotyping of the failing heart:is the left ventricular ejection fraction obsolete[J].JACC Heart Fail,2017,5(11):772-781.
[12]Tune JD,Goodwill AG,Sassoon DJ,et al.Cardiovascular consequences of metabolic syndrome[J].Transl Res,2017,183:57-70.
[13]Wang ML,Li SY,Zhou XY,et al.Increased inflammation promotes ventricular arrhythmia through aggravating left stellate ganglion remodeling in a canine ischemia model[J].Int J Cardiol,2017,248:286-293.
[14]Papadimitriou L,Hamo CE,Butler J.Heart failure guidelines:what′s new?[J].Trends Cardiovas Med,2017,27(5):316-323.
[15]王嵘,高长青,肖苍松,等.不同时机外科血运重建治疗心肌梗死后左心功能不全的回顾性研究[J].中华外科杂志,2014,52(12):929-933.
[16]李如意,王天红,许玉芳.慢性心力衰竭患者左心房结构及功能的改变[J].中国老年学杂志,2015,35(13):3556-3557.
[17]徐晓红,徐耕审.心脏磁共振成像在慢性心力衰竭诊断及治疗中的研究进展[J].中国循环杂志,2015,30(6):610-613.
[18]罗海营,钟小梅,刘辉,等.基于诊断标准心脏磁共振成像在致心律失常性右室心肌病诊断中的价值[J].中山大学学报:医学科学版,2014,35(6):907-913.
[19]周璐,金征宇,张竹花.心脏磁共振成像评价健康志愿者心脏的结构和功能[J].中国医学科学院学报,2009,31(2):210-214.
[20]尹静,滑少华,李莉锦,等.实时三维超声心动图对右心衰竭患者右心室收缩功能的应用[J].中国超声医学杂志,2016,32(12):1089-1092.