摘要
目的研究心脏磁共振(CMR)心肌延迟强化(LGE)对肥厚型心肌病(HCM)心源性猝死(SCD)长期风险的预测价值。方法选取我院2013年10月至2020年6月接受CMR-LGE的HCM患者81例为研究对象,统计所有患者的基本资料、5年HCM-SCD风险评分、LGE值及SCD发生率。Pearson相关性分析HCM患者LGE值与5年HCM-SCD风险评分的相关性,同时绘制ROC曲线计算LGE值对HCM患者SCD发生的预测效能。结果HCM患者的LGE值随着5年HCM-SCD风险评分增加而明显升高(P<0.01);Pearson相关性分析显示,HCM患者LGE值与5年HCM-SCD风险评分呈正相关(r=0.704,P<0.01);ROC曲线分析显示,LGE值预测HCM患者SCD发生风险的AUC为0.892,同时LGE≥5.47是最佳阈值,其诊断敏感度为100%、特异度为66.67%;Kaplan-Meier生存分析结果显示,LGE≥5.47组的存活率明显低于LGE<5.47组(P<0.01)。结论HCM患者LGE值能够有效预测患者SCD的发生风险,当HCM患者LGE≥5.47%时,应考虑提前给予植入型心律转复除颤器进行一级预防,以完善HCM患者的SCD风险分层。
Objective To investigate the predictive value of cardiac magnetic resonance(CMR)late gadolinium enhancement(LGE)on the long-term risk of sudden cardiac death(SCD)in hypertrophic cardiomyopathy(HCM).Methods A total of 81 patients with HCM who received CMR-LGE in our hospital from October 2013 to June 2020 were selected as the study subjects,the basic data,5-year HCM-SCD risk score and LGE values of all patients,and the incidence of SCD were counted.Pearson correlation analysis was used to analyze the correlation of LGE values and 5-year HCM-SCD risk score in patients with HCM,and ROC curves was drawn to calculate the predictive efficacy of LGE values on the occurrence of SCD in patients with HCM.Results The LGE values of patients with HCM increased significantly with the 5-year HCM-SCD risk score increasing(P<0.01);Pearson correlation analysis showed that the LGE values of patients with HCM was positively correlated with 5-year HCM-SCD risk score(r=0.704,P<0.01);The ROC curve analysis revealed that the AUC of LGE values of patients with HCM predicting the risk of SCD in patients with HCM was 0.892,meanwhile,the LGE≥5.47 was the optimal threshold,with diagnostic sensitivity of 100%,and the specificity of 66.67%;The results of the Kaplan-Meier survival analysis showed that the survival rate of the LEG≥5.47 group was significantly lower than that of the LGE<5.47 group(P<0.01).Conclusion The LGE value of patients with HCM can effectively predict the risk of SCD.When the LGE value of HCM patients is≥5.47%,implantable cardioverter defibrillator should be considered for primary prevention in advance to improve the risk stratification of SCD in HCM patients.
作者
刘力榛
陈家飞
罗俊
LIU Li-zhen;CHEN Jia-fei;LUO Jun(Department of Radiology,the First Hospital Affiliated to Army Medical University,Chongqing 400038,China;7T Magnetic Resonance Imaging Translational Medical Center,the First Hospital Affiliated to Army Medical University,Chongqing 400038,China)
出处
《局解手术学杂志》
2024年第10期910-915,共6页
Journal of Regional Anatomy and Operative Surgery
