心肌纤维化作为非缺血性心肌病患者室性心律失常的预测因子。
Myocardial Fibrosis as a Predictor of Ventricular Arrhythmias in Patients With Non-ischemic Cardiomyopathy.
机构信息
Department of Radiology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Department of Medical Informatics and Biostatistics, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
出版信息
In Vivo. 2021 May-Jun;35(3):1677-1685. doi: 10.21873/invivo.12427.
BACKGROUND/AIM: The aim of the study was to assess the relationship between myocardial fibrosis characteristics (percentage, localization, heterogeneity), evaluated by a non-invasive method such as cardiac magnetic resonance (CMR), with the extrasystolic ventricular arrhythmia in patients with non-ischemic cardiomyopathy.
PATIENTS AND METHODS
The study prospectively included 173 consecutive patients who underwent electrocardiogram Holter monitoring, transthoracic echocardiography and CMR with late gadolinium enhancement (LGE).
RESULTS
In univariate analysis, both the presence (OR=1.05, 95% CI=1.01-1.09; p=0.015), the percentage of fibrosis >15% (p=0.018), the septum size, the fibrosis in either lateral or septal walls (p=0.004), as well as fibrosis in the midwall (p=0.019) were statistically significant higher in the group with extrasystolic arrhythmia. After adjustment, the percentage of fibrosis >15%, had higher odds of extra systolic arrhythmia [OR=3.78 (95% CI=1.52-10.62, p=0.007)].
CONCLUSION
The presence, percentage, and localisation of left ventricle myocardial fibrosis characterized by LGE-CMR was associated with ventricular arrhythmias.
背景/目的：本研究旨在评估通过心脏磁共振（CMR）等非侵入性方法评估的心肌纤维化特征（百分比、定位、异质性）与非缺血性心肌病患者室性心律失常之间的关系。
患者与方法
本研究前瞻性纳入了 173 例连续接受心电图 Holter 监测、经胸超声心动图和钆延迟增强（LGE）CMR 的患者。
结果
在单因素分析中，室性心律失常组的室性早搏（OR=1.05，95%CI=1.01-1.09；p=0.015）、纤维化百分比＞15%（p=0.018）、室间隔大小、侧壁或室间隔纤维化（p=0.004）以及中壁纤维化（p=0.019）均有统计学意义。多因素调整后，纤维化百分比＞15%的患者发生室性心律失常的可能性更高[OR=3.78（95%CI=1.52-10.62，p=0.007）]。
结论
LGE-CMR 特征性左心室心肌纤维化的存在、百分比和定位与室性心律失常相关。
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