心肌梗死伴二尖瓣返流影响因素的心脏MR研究

Cardiac MR study on the factors of mitral regurgitation in patients with acute myocardial infarction

目的:采用心脏磁共振成像探究伴或不伴二尖瓣返流的心肌梗死患者的左心室结构和功能差异,并分析可能促使心肌梗死患者发生二尖瓣返流的影响因素。方法:回顾性分析心肌梗死患者131例,并将其分为不伴二尖瓣返流组(56例)以及伴二尖瓣返流组(75例),分析比较两组的一般临床资料、左心室结构功能数据及钆对比剂延迟强化数据。结果:与不伴二尖瓣返流组相比,伴二尖瓣返流组年龄更高;左心室收缩末期容积、左心室舒张末期容积、梗死面积更大、下壁梗死发生率更大(P均<0.05),并且左室射血分数更低(P<0.001)。结论:与不伴二尖瓣返流患者相比,伴二尖瓣返流患者左室结构与功能障碍更严重,年龄、下壁心肌梗死以及梗死面积可能是心肌梗死患者发生二尖瓣返流的影响因素,心脏磁共振成像能够为心肌梗死伴二尖瓣返流患者提供更多有助于诊疗的影像学信息。

Objective:To explore the difference of left ventricular structure and function in myocardial infarction patients with or without mitral regurgitation by cardiac magnetic resonance imaging,and to explore the factors of mitral regurgitation in patients with acute myocardial infarction.Methods:A total of 131 patients with myocardial infarction were retrospectively analyzed and divided into two groups:non-mitral regurgitation group(n=56)and mitral regurgitation group(n=75).The general clinical data,left ventricular structure and function data and late gadolinium enhancement data were compared and analyzed.Results:Compared with the group without mitral regurgitation,the group with mitral regurgitation was older in age,the left ventricular end-systolic volume,left ventricular end-diastolic volume,infarction area and the incidence of inferior wall infarction were larger(P<0.05).And the left ventricular ejection fraction was lower(P<0.001).Conclusion:The left ventricular structure and function of patients with mitral regurgitation are worse than those without mitral regurgitation.Age,inferior myocardial infarction and infarct size may be the predictors of mitral regurgitation in patients with myocardial infarction.Cardiac magnetic resonance imaging can provide more imaging information for the diagnosis and treatment of myocardial infarction with mitral regurgitation.