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心脏结节病患者晚期钆增强的定位及其与室性心动过速的关系。

Localization of Late Gadolinium Enhancement and Its Association with Ventricular Tachycardia in Patients with Cardiac Sarcoidosis.

机构信息

Department of Cardiovascular Medicine, Nippon Medical School.

Department of Radiology, Nippon Medical School.

出版信息

Int Heart J. 2022;63(2):235-240. doi: 10.1536/ihj.21-635.

DOI:10.1536/ihj.21-635
PMID:35354745
Abstract

Sustained ventricular tachycardia (sVT), leading to sudden cardiac death, is one of the common manifestations in cardiac sarcoidosis (CS). Although late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) has been reported to be associated with sVT, the relationships of its localization to sVT have not been fully evaluated.To evaluate the localization of LGE and its relationships to sVT in patients with CS, we reviewed medical record of consecutive 31 patients with CS who underwent CMR. The localization of LGE was divided into four categories: Left ventricular (LV) septum, LV free wall, right ventricular (RV) septum, and RV free wall. We investigated the association of sVT with localization of LGE and other parameters including serum biomarkers LV ejection fraction on echocardiography and Fluorine-18-fluorodeoxyglucose (FDG) accumulation on positron emission tomography (PET) -CT.Of the studied population, 8 patients (25.8%) were known to present with sVT among 31 CS patients. LGE was observed in the RV free wall in 6 patients with sVT, whereas it was in 5 patients without sVT (75.0% versus 21.7%, P = 0.022). Univariate analysis showed that only LGE in the RV free wall was associated with sVT (odds ratio [OR]: 10.80; 95% confidence interval [CI]: 1.64-70.93, P = 0.013).LGE in the RV free wall was associated with sVT in patients with CS.

摘要

持续性室性心动过速(sVT)导致心源性猝死是心脏结节病(CS)的常见表现之一。尽管心脏磁共振(CMR)上的晚期钆增强(LGE)已被报道与 sVT 相关,但 LGE 的定位与其与 sVT 的关系尚未得到充分评估。为了评估 CS 患者中 LGE 的定位及其与 sVT 的关系,我们回顾了连续 31 例接受 CMR 的 CS 患者的病历。LGE 的定位分为四个类别:左心室(LV)间隔、LV 游离壁、右心室(RV)间隔和 RV 游离壁。我们研究了 sVT 与 LGE 定位以及其他参数(包括超声心动图上的 LV 射血分数和正电子发射断层扫描(PET)-CT 上的氟-18-氟代脱氧葡萄糖(FDG)积聚)之间的关系。在研究人群中,31 例 CS 患者中有 8 例(25.8%)已知存在 sVT。6 例 sVT 患者的 RV 游离壁观察到 LGE,而 5 例无 sVT 患者观察到 LGE(75.0%与 21.7%,P=0.022)。单因素分析显示,只有 RV 游离壁的 LGE 与 sVT 相关(比值比[OR]:10.80;95%置信区间[CI]:1.64-70.93,P=0.013)。CS 患者 RV 游离壁的 LGE 与 sVT 相关。

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