基于心脏磁共振右心室⁃肺动脉耦联参数在评估CTD⁃PH危险分层中的研究
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R445.2

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国家自然科学基金(81601464,61871117)


The study of CMR based right ventricular ⁃pulmonary arterial coupling in the assessment of CTD⁃PH risk stratification
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    目的:探讨基于心脏磁共振(CMR)右心室-肺动脉耦联(VAC)参数在评估结缔组织疾病相关肺动脉高压(CTD-PH) 危险分层中的应用价值。方法:回顾性分析2018年6月—2022年4月期间62例CTD-PH患者临床及CMR资料,根据危险分层将其分为组1(低危及中低危患者,n=39例)和组2(中高危及高危患者,n=23例),并对患者的左右心室容积、功能参数、左心室心肌组织学参数及VAC进行分析,寻找用于预测CTD-PH危险分层的最佳模型。结果:右心室容积功能参数和右心室插入部的组织学参数在两组PH患者间的差异有统计学意义(P < 0.05)。右心室舒张末期容积指数(RVEDVI)和VAC具有独立预测效能,联合RVEDVI和VAC具有最高的预测准确性(AUC=0.839,95%CI:0.735~0.944,P < 0.001)。结论:右心室相关的容积、功能参数和右心室插入部的组织学参数可用于评估CTD-PH危险分层,联合RVEDVI和VAC可提高评估危险分层的准确性。

    Abstract:

    Objective:To investigate the value of cardiac magnetic resonance(CMR)based right ventricular-pulmonary arterial coupling(VAC)parameters in assessing risk stratification of connective tissue disease-related pulmonary hypertension(CTD-PH). Methods:The clinical and CMR data of 62 patients with CTD-PH between June 2018 and April 2022 were retrospectively analyzed, and they were divided into group 1(low-risk and low-to-moderate-risk patients,n=39)and group 2(moderate-to-high-risk and high-risk patients,n=23)according to risk stratification,and the patients’right and left ventricle-related volumetric and functional parameters, left ventricular tissue characterization parameters and VAC were statistically analyzed. The optimal model was sought to predict CTD- PH risk stratification. Results:The differences in right ventricle-related volumetric and functional parameters,and tissue characterization parameters of the right ventricular insertion were statistically significant in the two groups of patients with CTD -PH (P < 0.05). The right ventricular end-diastolic point(RVIP)volume index(RVEDVI)and VAC were independent predictors,and the combination of RVEDVI and VAC had the best predictive accuracy(AUC=0.839,95% CI:0.735~0.944,P < 0.001). Conclusion: Right ventricle-related volumetric and functional parameters,and RVIP tissue characterization parameters can be used to assess CTD- PH risk stratification;the combination of RVEDVI and VAC improves the accuracy of assessing risk stratification.

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马珂凡,刘王琰,王嫱,孙晓萱,祝因苏,徐怡.基于心脏磁共振右心室⁃肺动脉耦联参数在评估CTD⁃PH危险分层中的研究[J].南京医科大学学报(自然科学版),2023,(8):1121-1127

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  • 收稿日期:2023-02-19
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  • 在线发布日期: 2023-08-10
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