扩张型心肌病患者左心室球形度与附壁血栓的相关性分析

The Correlation Between Left Ventricular Sphericity and Mural Thrombus in Patients with Dilated Cardiomyopathy

目的探究扩张型心肌病(DCM)患者左心室球形度与附壁血栓的相关性。方法收集2013年1月至2019年6月于郑州大学第一附属医院心内科因心衰住院诊断为DCM的患者,根据是否形成附壁血栓并经过年龄与性别配对后,纳入研究组与对照组56对,共112例。收集两组一般临床资料及心脏磁共振结果,比较两组间左心室球形度及其他相关指标的差异有无统计学意义。绘制ROC曲线进一步分析左心室球形度的诊断价值。结果 (1)结果分析显示,两组房扑或房颤发生率、左心室射血分数、左室球形度比较,差异有统计学意义(均P<0.05)。研究组的左室球形度高于对照组[(66.93±15.80)%比(48.27±9.78)%](P<0.001)。两组间其他指标差异无统计学意义(均P>0.05)。(2)ROC曲线分析显示,左心室球形度以54.44%作为分界值时,其敏感度和特异度分别为82.9%和75.6%;左心室球形度以60.27%作为分界值时,其敏感度和特异度分别为68.3%和90.2%。结论 DCM患者左心室球形度与附壁血栓呈独立正相关性。

Objective To explore the correlation between left ventricular sphericity and mural thrombus in patients with dilated cardiomyopathy(DCM).Methods From January 2013 to June 2019, 56 pairs of patients(112 patients) with DCM in the Department of Cardiology, the First Affiliated Hospital of Zhengzhou University, were enrolled in the study group and the control group after age and sex matching. The general clinical data and the results by cardiac magnetic resonance measurements were collected. The differences of left ventricular sphericity and other related indexes between the two groups were compared. The ROC curve was drawn to analyze the diagnostic value of left ventricular sphericity.Results(1)There were significant differences in incidences of atrial fibrillation or flutter, left ventricular ejection fraction and left ventricular sphericity between the two groups(all P<0.05). The left ventricular sphericity in the study group was significantly higher than that in the control group[(66.93±15.80)% VS(48.27±9.78)%](P<0.001). There was no significant difference in other indexes between the two groups(all P>0.05).(2)ROC curve analysis showed that when the left ventricular sphericity was 54.44%, the sensitivity and specificity were 82.9% and 75.6% respectively;when the left ventricular sphericity was 60.27%, the sensitivity and specificity were 68.3% and 90.2% respectively.Conclusion Left ventricular sphericity is independently and positively correlated with mural thrombus in patients with DCM.