心脏磁共振对硬膜外阻滞治疗心衰的疗效评价

Using cardiac magnetic resonance imaging to evaluate refractory heart failure before and after treatment of epidural block

目的探讨心脏磁共振(cardiac magnetic resonance,CMR)对心衰患者经高位胸段硬膜外麻醉阻滞治疗前后心脏功能及心肌纤维化的评价能力及应用价值。方法选择确诊为顽固性心衰患者12例行上胸段硬膜外交感神经阻滞治疗30天,同时接受心衰常规治疗,并于治疗前、后分别进行心脏磁共振扫描,得出射血分数(ejection fraction,EF)、舒张末容积(end diastolic volume,EDV)、收缩末容积(end systolic volume,ESV)、舒张末室壁质量(end diastolic wall mass,EDWM)、左心室心肌延迟强化体积及左心室心肌延迟强化率(即左心室心肌延迟强化体积占左心室心肌总体积的百分比)的数据。结果患者治疗前、后EF值、左心室心肌延迟强化体积及左心室心肌延迟强化率的结果差异有统计学意义,而EDV、ESV、EDWM值治疗前、后的结果差异无统计学意义(P<0.05)。结论CMR能够对经硬膜外阻滞治疗后的心衰患者进行心脏功能及心肌纤维化的疗效评估。

Objective We aimed to use CMR imaging to evaluate cardiac function and myocardial fibrosis of heart failure before and after treatment by high thoracic epidural block.Methods 12 patients who had been diagnosed with refractory heart failure accepted both high thoracic epidural block therapy and also conventional drugs for 30 days.We used cardiac MRI examination to achieve EF,EDV,ESV,EDWM,left ventricular delayed enhancement volume and rate before and after treatment.Results The results(EF,left ventricular delayed enhancement volume and rate)before and after treatment differences were statistically significant,and the testing results of EDV,ESV,EDWM value before and after the treatment differences were not statistically significant.Conclusion CMR can evaluate cardiac function and myocardial fibrosis in patients with heart failure after epidural block therapy.