心脏磁共振初始T1值在老年肥厚型心肌病心肌纤维化评估中的应用价值

Application value of initial T1 value of cardiac magnetic resonance in evaluating myocardial fibrosis in elderly patients with hy-pertrophic cardiomyopathy

中文关键词: 老年  心脏磁共振  肥厚型心肌病  心肌纤维化

英文关键词: elderly  cardiac magnetic resonance  hypertrophic cardiomyopathy  myocardial fibrosis

中文摘要:

      目的 研究心脏磁共振(CMR)初始T1值在老年肥厚型心肌病(HCM)心肌纤维化评估中的应用价值.方法 回顾性分析2022年7月-2024年12月复旦大学附属华东医院就诊的老年HCM患者56例,所有患者均接受CMR检查.根据是否存在钆延迟强化(LGE)将老年HCM患者分为LGE阳性组(n=25)和LGE阴性组(n=31),比较2组的一般资料和心脏磁共振参数.应用美国心脏协会17节段心肌模型将老年HCM患者心肌节段分为LGE阳性节段、LGE阴性肥厚节段和LGE阴性不肥厚节段,选取同期20例CMR检查正常的老年患者心肌节段作为对照节段,比较各组初始T1值.通过受试者工作特征(ROC)曲线分析初始T1值对局灶性纤维化的诊断效能.结果 LGE阳性组和LGE阴性组患者年龄、性别和收缩压等一般资料差异均无统计学差异(P＞0.05).初始T1值在LGE阳性节段、LGE阴性肥厚节段、LGE阴性不肥厚节段及对照节段间,两两组间比较差异均有统计学意义,其中LGE阳性节段的初始T1值最高.ROC曲线显示,心肌初始T1值识别局灶性纤维化的曲线下面积为0.90,截断值为1 312 ms,敏感度为83.67％,特异度为86.59％.结论 初始T1值对老年HCM患者局灶性纤维化可能具有较高的诊断价值.

英文摘要:

      Objective To investigate the application value of initial T1 value of cardiac magnetic resonance(CMR)in evaluating myocardial fibrosis in elderly patients with hypertrophic cardiomyopathy(HCM).Methods A retrospective analy-sis was conducted on 56 elderly HCM patients admitted to Huadong Hospital,Fudan University from July 2022 to December 2024.All patients underwent CMR examination.Based on the presence of late gadolinium enhancement(LGE),they were di-vided into LGE-positive group(n=25)and LGE-negative group(n=31).The general clinical characteristics and CMR param-eters were compared between the two groups.According to the 17-segment myocardial model of the American Heart Association,the myocardial segments of elderly patients with HCM were classified as LGE-positive segments,LGE-negative hypertrophic seg-ments and LGE-negative non-hypertrophic segments.20 elderly patients with normal CMR examination during the same period were served as the control segments.The initial T1 values were compared among these groups.The receiver operating charac-teristic(ROC)curve was used to analyze the diagnostic efficacy of the initial T1 value for focal fibrosis.Results No signifi-cant differences were observed in the general clinical characteristics such as age,gender,and systolic blood pressure between the LGE-positive group and LGE-negative group(P＞0.05).The initial T1 values showed statistically significant differences in pairwise comparisons among LGE-positive segments,LGE-negative hypertrophic segments,LGE-negative non-hypertrophic segments and control segments.Among them,the initial T1 value of the LGE-positive segment was the highest.The ROC curve showed that the area under the curve of the initial T1 value of the myocardium for identifying focal fibrosis was 0.90,the cut-off value was 1 312 ms,the sensitivity was 83.67％,and the specificity was 86.59％.Conclusion The initial T1 value may have high diagnostic value for focal fibrosis in elderly HCM patients.