Wysocki Andrzej, Macek Piotr, Dziadkowiec-Macek Barbara, Poręba Małgorzata, Gać Paweł, Poręba Rafał
Centre of Diagnostic Imaging, 4th Military Hospital, 50-981 Wroclaw, Poland.
Department of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland.
J Clin Med. 2024 Sep 11;13(18):5383. doi: 10.3390/jcm13185383.
: Arterial hypertension (AH) is one of the major risk factors for cardiovascular diseases. An association between untreated AH and arrhythmia is observed. Cardiac magnetic resonance (CMR) assesses myocardial fibrosis by detecting foci of late gadolinium enhancement (LGE). Clinical significance of LGE at the right ventricular insertion point (RVIP) is not fully established. This study aimed to assess the relationship between the presence of LGE at the RVIP determined by CMR and the incidence of arrhythmia in a group suffering from arterial hypertension. : The study group consisted of 81 patients with AH (37 men and 44 women, age: 56.7 ± 7.1 years). All subjects underwent CMR and 24 h Holter ECG monitoring. Two subgroups were distinguished in the study group based on the criterion of the presence of LGE at the RVIP in CMR. The RVIP+ subgroup consisted of patients with LGE at the RVIP, while the RVIP- group consisted of patients without LGE at the RVIP. : The RVIP+ subgroup was characterized by higher maximum and minimum heart rates in 24 h Holter ECG recordings compared to the RVIP- subgroup ( < 0.05). The RVIP+ subgroup had a statistically significantly higher number of single premature supraventricular beats, supraventricular tachycardias, and single premature ventricular beats than the RVIP- subgroup ( < 0.05). Regression analysis documented that a longer duration of AH (counted from diagnosis) as well as the occurrence of LGE at the RVIP (assessed by CMR) are independent risk factors for arrhythmia ( < 0.05). : Due to the possibility of detecting LGE at the RVIP, CMR may be a useful diagnostic method in estimating the risk of arrhythmias in the group of patients with AH.
动脉高血压（AH）是心血管疾病的主要危险因素之一。未经治疗的AH与心律失常之间存在关联。心脏磁共振成像（CMR）通过检测钆延迟强化（LGE）病灶来评估心肌纤维化。右心室插入点（RVIP）处LGE的临床意义尚未完全明确。本研究旨在评估CMR测定的RVIP处LGE的存在与动脉高血压患者心律失常发生率之间的关系。：研究组由81例AH患者组成（37例男性和44例女性，年龄：56.7±7.1岁）。所有受试者均接受了CMR检查和24小时动态心电图监测。根据CMR中RVIP处LGE的存在标准，在研究组中区分出两个亚组。RVIP +亚组由RVIP处有LGE的患者组成，而RVIP -组由RVIP处无LGE的患者组成。：与RVIP -亚组相比，RVIP +亚组在24小时动态心电图记录中的最高和最低心率更高（<0.05）。RVIP +亚组的单个房性早搏、室上性心动过速和单个室性早搏的数量在统计学上显著高于RVIP -亚组（<0.05）。回归分析表明，AH的持续时间更长（从诊断开始计算）以及RVIP处出现LGE（通过CMR评估）是心律失常的独立危险因素（<0.05）。：由于有可能检测到RVIP处的LGE，CMR可能是评估AH患者心律失常风险的一种有用的诊断方法。
