首页|基于心脏磁共振晚期钆增强的心肌信号强度异质性对心肌炎患者预后价值的研究

基于心脏磁共振晚期钆增强的心肌信号强度异质性对心肌炎患者预后价值的研究

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目的 探讨左心室熵在心肌炎患者预后评估中的应用价值.材料与方法 收集自2015年7月至2023年10月山东省立医院临床诊断为心肌炎的患者共56例,分析其临床指标、心脏磁共振参数及左心室熵.根据患者是否发生主要不良心血管事件(major adverse cardiovascular events,MACE)分为预后良好组(42例)和预后不良组(14例);通过受试者工作特征(receiver operator characteristic,ROC)曲线分析评估左心室熵的预测价值,采用生存函数分析(Kaplan-Meier法,K-M)绘制生存曲线,应用Log-rank检验K-M曲线.结果 在随访过程中,14例患者(25.00%)发生MACE,预后不良组患者的左心室熵显著增高(P<0.001).ROC曲线分析显示,左心室熵的ROC曲线下面积为0.871,敏感度为78.5%,特异度为83.2%.K-M分析显示,左心室熵≥7.805患者的总生存率低于左心室熵<7.805患者(P<0.001).结论 左心室熵对预测心肌炎患者MACE的发生有一定的参考价值,有助于临床更好地评价心肌炎患者的预后.
Prognostic value of myocardial signal intensity heterogeneity based on late gadolinium enhancement in cardiac magnetic resonance in patients with myocarditis
Objective:To evaluate the prognostic role of left ventricular(LV)entropy in patients with myocarditis.Materials and Methods:A total of 56 consecutive patients diagnosed with clinically suspected myocarditis between July 2015 and October 2023 were included in this retrospective study.Clinical indicators,conventional cardiac magnetic resonance(CMR)parameters and LV entropy were assessed.Patients were categorised into good prognosis(n=42)and poor prognosis groups(n=14)according to whether they experienced major adverse cardiovascular events(MACE).Prognostic efficacy of LV entropy was assessed by receiver operating characteristic(ROC)curves.Kaplan-meier(K-M)analysis was used for survival analysis,and Log-rank test was used for survival comparison.Results:During follow-up 14 patients(25.00%)experienced MACE,and LV entropy was significantly higher in patients who experienced MACE(P<0.001).ROC curve analysis indicated that the area under ROC curve(AUC)of the LV entropy was 0.871,the sensitivity was 78.5%and the specificity was 83.2%.K-M analysis suggested that the overall survival rate was lower in patients with LV entropy≥7.805 than in patients with LV entropy<7.805(P<0.001).Conclusions:LV entropy could help predict the occurrence of MACE in patients with myocarditis,and contribute to a better clinical evaluation of the prognosis of patients with myocarditis.

myocarditismajor adverse cardiac eventscardiac magnetic resonance imagingleft ventricular entropyT1 mappingmagnetic resonance imaging

刘方圆、高艳、王文先、史荣超、李莎、王锡明

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山东大学医学融合与实践中心,济南 250012

山东省立医院影像科,济南 250021

心肌炎 主要心血管不良事件 心脏磁共振 左心室熵 T1 mapping 磁共振成像

国家自然科学基金

82271993

2024

磁共振成像
中国医院协会 首都医科大学附属北京天坛医院

磁共振成像

CSTPCD北大核心
影响因子:1.38
ISSN:1674-8034
年,卷(期):2024.15(3)
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