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扩张型心肌病患者的心肌纤维化。图像分析在心肌活检中的应用。

The myocardial fibrosis in patients with dilated cardiomyopathy. The application of image analysis in the myocardial biopsies.

作者信息

Agapitos E, Kavantzas N, Nanas J, Margari Z, Bakouris M, Kassis K, Panolaridis A, Davaris P

机构信息

Department of Pathology, Medical School, National and Capodistrian University of Athens, Greece.

出版信息

Gen Diagn Pathol. 1996 May;141(5-6):305-11. doi: 10.1117/12.238788.

Abstract

BACKGROUND

The aim of our study is to investigate whether myocardial fibrosis measured by image analysis may be considered as an important and accurate index of dilated cardiomyopathy and its prognosis.

METHODS

The study group consisted of 24 patients with dilated cardiomyopathy, which was diagnosed by echocardiography, radionuclide ventriculography, cardiac catheterization, and left ventricular endomyocardial biopsy. The patients' overall disability was conventionally expressed with the criteria for functional capacity. Using image analysis, the percentage of fibrosis in a total of 35 myocardial biopsies was accurately measured, followed by a study comparing the percentage of myocardial fibrosis and the clinical parameters (left ventricular ejection fraction and overall functional capacity), showing the degree of each patient's heart failure.

RESULTS

A correlation was found among fibrosis, left ventricular ejection fraction, and overall functional capacity. The cases with small values of fibrosis (< 10%) have big values of ejection fraction and belong to Class I of overall functional capacity. The cases with big values of fibrosis (> 10%) belong to Classes III and IV of overall functional capacity and have small values of ejection fraction. The results of the comparative study were graphically presented and considered significant.

CONCLUSION

Myocardial fibrosis measured by image analysis might be considered an important prognostic index of dilated cardiomyopathy.

摘要

背景

我们研究的目的是调查通过图像分析测量的心肌纤维化是否可被视为扩张型心肌病及其预后的一个重要且准确的指标。

方法

研究组由24例扩张型心肌病患者组成,这些患者通过超声心动图、放射性核素心室造影、心导管检查和左心室心内膜活检确诊。患者的整体残疾程度按功能能力标准常规表示。使用图像分析准确测量了总共35份心肌活检标本中的纤维化百分比,随后进行了一项研究,比较心肌纤维化百分比与临床参数(左心室射血分数和整体功能能力),以显示每位患者的心力衰竭程度。

结果

发现纤维化、左心室射血分数和整体功能能力之间存在相关性。纤维化值较小(<10%)的病例射血分数值较大,属于整体功能能力I级。纤维化值较大(>10%)的病例属于整体功能能力III级和IV级,射血分数值较小。比较研究的结果以图表形式呈现并被认为具有显著性。

结论

通过图像分析测量的心肌纤维化可能被视为扩张型心肌病的一个重要预后指标。

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