功能磁共振成像对肺动脉高压患者心肌损伤的评估价值

Value of functional magnetic resonance imaging in evaluating myocardial injury in patients with pulmonary hypertension

目的分析功能磁共振成像对肺动脉高压患者心肌损伤的评估价值。方法随机选取本院2017年1月-2018年1月收治的肺动脉高压患者80例,将其纳入病例组。另于同期选取体检健康者80人,作为对照组。采用功能磁共振成像1.5T超导型扫描仪检查,随访6个月统计2组不良事件,包括血流动力学恶化、心功能恶化、心功能衰竭。结果病例组左室心肌质量指数(26.59±3.53)g/m2、左室每搏输出量指数(30.61±1.63)mL/m^2、左室舒张末容积指数(65.96±0.23)mL/m^2、左室心脏指数(1.57±0.26)L/(min·m^2)、左室收缩末容积指数(30.57±1.28)mL/m^2,低于对照组(P<0.001)。病例组右室每搏输出量指数(30.74±3.24)mL/m^2、右室收缩末容积指数(31.57±2.37)mL/m2,低于对照组(P<0.001),右室心肌质量指数(21.51±3.51)g/m2、右室舒张末期容积指数(101.59±1.65)mL/m^2、右室心脏指数(3.57±0.26)L/(min·m^2),高于对照组(P<0.001)。病例组肺动脉主干内径峰值流速(45.74±1.62)cm/s、肺动脉主干内径膨胀性(20.18±2.61)%,小于对照组(P<0.001)。病例组不良事件发生率(41.25%)高于对照组(5.00%,χ^2=6.874,P<0.001)。结论功能磁共振成像能较好反映肺动脉高压患者心肌损伤情况,预测肺动脉高压不良事件,建议使用。

Objective To investigate the value of functional magnetic resonance imaging(MRI)in evaluating myocardial injury in patients with pulmonary hypertension.Methods A total of 80 inpatients with pulmonary hypertension(a case group)and 80 healthy individuals(a control group)from January 2017 to January 2018 were enrolled.The patients received the functional MRI.The adverse events including deterioration of hemodynamics,deterioration of cardiac function,and failure were recorded during the 6-month follow-up.Results The left ventricular mass index[(26.59±3.53)g/m^2],left ventricularoutputperstrokeindex[(30.61±1.63)mL/m^2],leftventricularend-diastolicvolumeindex[(65.96±0.23)mL/m^2],left ventricular heart index[(1.57±0.26)L/(min·m^2)],and left ventricular end-systolic volume index[(30.57±1.28)mL/m^2]were lower in the case group than those in the control group(P<0.001).In the case group,the index of right ventricular output per stroke[(30.74±3.24)mL/m^2],and the index of right ventricular end-systolic volume[(31.57±2.37)mL/m^2]were lower than those in the control group(P<0.001),the index of right ventricular mass[(21.51±3.51)g/m2],the index of right ventricular end-diastolic volume[(101.59±1.65)mL/m^2],and the index of right ventricular heart[(3.57±0.26)L/(min·m^2)]were higher than those in the control group(P<0.001).The peak velocity of the inner diameter of the pulmonary trunk[(45.74±1.62)cm/s],and the dilatancy of the inner diameter of the pulmonary trunk[(20.18±2.61)%]in the case group were smaller than those in the control group(P<0.001).The incidence of adverse events(41.25%)in the case group was higher than that in the control group(5.00%,χ^2=6.874,P<0.001).Conclusion The functional magnetic resonance imaging can reflect the myocardial injury,and predict the adverse events of pulmonary hypertension patients.