扩张型心肌病左心结构功能心脏磁共振评价与NT-proBNP相关性研究

Evaluation of left ventricular function by cardiac magnetic imaging in dilated cardiomyopathy and the relationship with plasma NT-proBNP levels

目的 :扩张型心肌病(Dilated cardiomyopathy,DCM)主要引起左心室扩大和功能障碍,具有较高的发病率和死亡率。本研究通过心脏磁共振(CMR)电影评价DCM患者左心室结构功能,并探讨其与血浆NT-proBNP水平的相关性。方法:经完整临床资料诊断为扩张型心肌病的患者22例纳入研究,所有患者接受CMR电影检查及血浆NT-proBNP水平检测。CMR扫描数据导入后处理软件cardiac explorer获得左心室结构功能参数值,包括左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)、心指数(CI)、左室心肌质量(LVMM)、短轴缩短率(FS)、左心室舒张末期内径(LVEDD)、球形指数(SI)。上述左心室结构功能参数值与血浆NT-proBNP水平行相关性分析。结果:血浆NT-proBNP水平与LVEDV(r=0.596,P=0.003)、LVESV(r=0.742,P=0.000)、LVMM(r=0.763,P=0.000)、LVEDD(r=0.629,P=0.002)呈正相关关系,与LVEF(r=-0.829,P=0.000)、FS(r=-0.623,P=0.002)、SI(r=-0.539,P=0.010)呈负相关关系,其中与LVEF相关性最高。结论:CMR可以很好反映DCM左室重构后结构与功能的改变,DCM患者左心室腔扩大越明显、心肌质量增加越重,血浆NT-proBNP水平越高,提示血浆NT-proBNP水平与心室重构的严重程度相关。

Objective： Dilated cardiomyopathy（DCM） is characterized with left ventricular dilatation and dysfunction, which has a high morbidity and mortality. Our study is to investigate relationship between the left ventricular function by cardiac magenetic imaging（CMR） and plasma NT-proBNP levels in DCM. Methods： Twenty-two cases of DCM were enrolled. All patients received CMR examination and NT-proBNP level test. The imaging data of CMR were transferred to cardiac explorer workstation and the parameters of left ventricular structure and function were calculated. The parameters included LVEDV,LVESV, LVEF, SV, CO, CI, LVMM, FS, LVEDD, and SI. The correlation between all the parameters and plasma NT-proBNP levels was analyzed. Result： The plasma NT-proBNP levels in patients with DCM had a linear correlation with LVEDV,LVESV, LVEF, LVMM, FS, LVEDD and SI. The plasma NT-proBNP levels showed a positive correlation with LVEDV（r =0.596, P=0.003）, LVESV（r=0.742, P=0.000）, LVMM（r=0.763, P=0.000） and LVEDD（r=0.629, P=0.002） and negative correlation with LVEF（r=-0.829, P=0.000）, FS（r=-0.623, P=0.002） and SI（r=-0.539, P=0.010）. The coefficient of correlation between plasma NT-proBNP levels and LVEF was the highest. Conclusion： CMR can provide more valuable information for left ventricular remodeling and function in DCM patients. The more dilatation of the left ventricular chamber, the worse the cardiac function,the heavier the myocardial burden, and the higher the plasma NT-proBNP levels are. It demonstrates that the plasma NT-proBNP levels can reflect the severity of cardiac structure and function, and further reflect the severity of ventricular remodeling.