心脏磁共振延迟增强成像对肥厚型心肌病患者心肌纤维化的随访评估OA

Objective To explore the value of late gadolinium enhancement(LGE)technology based on cardiac magnetic resonance imaging(CMR)in assessing left ventricular myocardial fibrosis in patients with hypertrophic cardiomyopathy(HCM)during follow-up.Methods A retrospective study was conducted on 21 patients with HCM who underwent two cardiac magnetic resonance examinations(CMR1-CMR2).All patients completed CMR examinations,from which cine and LGE images were ac-quired.Left and right ventricular function and LGE parameters were analyzed,and relevant clinical data of the patients were collect-ed.Paired t-test was used to compare left and right ventricular functional parameters.Results At the first CMR scan(CMR1),10 HCM patients had LGE.The interval between CMR1 and CMR2 was(24.86±15.25)months.During follow-up,the incidence of LGE in HCM patients gradually increased,but the difference was not statistically significant(P＞0.05).However,the total amount of LGE in HCM patients increased significantly[0.80％(0％,3.60％)vs.5.3％(1.35％,8.60％),P＜0.001].With disease progression,maximum left ventricular end-diastolic thickness increased significantly in HCM patients[17.00 mum(15.00 mm,19.00 mm)vs.18.00 mm(16.00 mm,19.00 mm),P=0.027].However,there was no statistically significant difference in left and right ventricular ejection fraction,left ventricular mass and left ventricular remodel index between CMR1 and CMR2(all P＞0.05).In addition,the maximum increase in left ventricular end-diastolic thickness(r=0.550,P=0.014)and left ventricular mass(r=0.516,P=0.028)was positively correlated with the increase in LGE in HCM patients.Conclusion The myocardial fi-brosis of HCM patients increases with disease progression,and the increase correlates with the increase of left ventricular mass and end-diastolic peak thickness.