非缺血性扩张型心肌病患者NT-proBNP与心脏磁共振初始T1值的相关性

Correlation Between NT-proBNP and Cardiac Magnetic Resonance Native T1 in Non-Ischemic Dilated Cardiomyopathy

目的探讨非缺血性扩张型心肌病(NIDCM)患者氨基末端B型利钠肽前体(NT-proBNP)与心脏磁共振(CMR)初始T1值的关系。资料与方法回顾性收集2018年3月—2020年9月南京医科大学第一附属医院收治的NIDCM患者113例,经CMR测量左心室射血分数≤50%且左心室舒张末期容积指数>59.12 ml/m^(2)。测量反映心肌纤维化指标左心室中部室间隔初始T1值及增强后T1值,并计算细胞外容积。根据NT-proBNP的三分位数将患者分为NT-proBNP≤904 pg/ml组、905~2767 pg/ml组及>2767pg/ml组,比较不同水平NT-proBNP患者临床与CMR参数的差异,用线性回归及限制性立方样条模型研究NT-proBNP与室间隔初始T1值的相关性。结果3个NT-proBNP水平组室间隔初始T1值及细胞外容积比较,差异均有统计学意义(F=6.820、3.700,P均<0.05)。限制性立方样条模型显示,NT-proBNP与室间隔初始T1值呈非线性相关(P=0.001);当NT-proBNP>1105 pg/ml时,NT-proBNP与室间隔初始T1值呈正相关(β=22.76,95%CI 9.83~35.70,P<0.001)。结论NIDCM患者NT-proBNP与室间隔初始T1值呈非线性相关。NT-proBNP>1105 pg/ml时,NT-proBNP升高与心肌纤维化严重程度呈正相关。

Purpose To evaluate the relationship between N-terminal pro-B-type natriuretic peptide(NT-proBNP)and cardiac magnetic resonance(CMR)native T1 in patient with non-ischemic dilated cardiomyopathy(NIDCM).Materials and Methods A total of 113 patients diagnosed with NIDCM left ventricular ejection fraction≤50%and left ventricular end diastolic volume index>59.12 ml/m^(2) in CMR from March 2018 to September 2020 in the First Affiliated Hospital of Nanjing Medical University were retrospectively enrolled.Parameters reflecting myocardial fibrosis included septal native T1 value,enhancement T1 value and extracellular volume were evaluated.All patients were divided into three groups according to the tertile of NT-proBNP,including NT-proBNP≤904 pg/ml group,905-2767 pg/ml group and>2767 pg/ml group.The differences between clinical and CMR parameters of patients with different levels of NT-proBNP were compared.Linear regression models and restricted cubic spline model were used to further explore the relationship between NT-proBNP and septal native T1.Results There were significant differences in septal native T1 value and ECV among three groups(F=6.820 and 3.700,all P<0.05).The restricted cubic spline curve exhibited a non-linear relationship between NT-proBNP and septal native T1 value(P=0.001).When NT-proBNP>1105 pg/ml,NT-proBNP was positively correlated with septal native T1(β=22.76,95%CI 9.83-35.70,P<0.001).Conclusion A non-linear relationship between NT-proBNP and septal native T1 value was demonstrated in patient with NIDCM.When NT-proBNP>1105 pg/ml,the increase of NT-proBNP was positively correlated with the severity of myocardial fibrosis.