3.0 T心脏磁共振对IIM心肌纤维化与新型心脏损伤标志物YKL-40的关系研究
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南京医科大学第一附属医院心血管内科

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国家自然科学基金项目(面上项目,重点项目,重大项目);江苏省医学重点人才


Relationship between novel cardiac injury marker YKL-40 and myocardial fibrosis of idiopathic inflammatory myopathy: accessed by 3.0 T cardiac magnetic resonance
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Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University

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The National Natural Science Foundation of China (General Program, Key Program, Major Research Plan); Key Medical People Project in Jiangsu Province

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    摘要:

    目的:运用 3.0 T 心脏磁共振(cardiac magnetic resonance,CMR)对特发性炎症性肌病(idiopathic inflammatory myopathy,IIM)心肌纤维化进行定量检测,并分析与心脏损伤标志物几丁质酶3样蛋白1(chitinase-3-like-1 protein,YKL-40)的关系,从而探究血清YKL-40在反应IIM心肌损伤患者心肌纤维化程度中的价值。方法:回顾性纳入2018年5月至2022年8月在南京医科大学第一附属医院就诊的IIM患者64例。所有患者均行3.0T CMR扫描并测定血清YKL-40。采用t检验、Mann-Whitney U检验或χ2检验比较心肌损伤组与无心肌损伤组各指标差异;采用Spearman相关分析和线性回归分析IIM患者血清YKL-40与CMR参数间的关系。结果:与无心肌损伤患者相比,IIM合并心肌损伤患者年龄[(53.0±13.0)岁 vs. (44.6±16.1)岁]、血清YKL-40[73.4(46.9,119.3)ng/mL vs. 48.1(22.5,65.1)ng/mL]、初始T1值(Native T1)[(1263.2±50.3)ms vs.(1221.8±59.3)ms]及细胞外容积比例(extracellular volume,ECV)[(31.7±5.6)% vs.( 28.7±3.2)%]更高,左心室心搏输出量指数(left ventricular stroke volume index,LVSVI)更低[(42.3±10.2)mL/m2 vs. (49.0±11.1)mL/m2](均P<0.05)。血清YKL-40与ECV(r=0.373,P=0.004)呈正相关。多元线性回归分析示血清YKL-40与ECV独立相关。 结论:血清YKL-40可以反映IIM心肌损伤患者的心肌纤维化程度。

    Abstract:

    Objective:To quantitatively detect myocardial fibrosis of idiopathic inflammatory myopathy(IIM) by 3.0 T cardiac magnetic resonance(CMR), and to analyse the relationship with cardiac injury marker chitinase 3-like-1 protein (YKL-40), to explore the value of serum YKL-40 in reflecting the degree of myocardial fibrosis in IIM patients with myocardial injury. Methods:64 IIM patients who visited the First Affiliated Hospital of Nanjing Medical University from May 2018 to August 2022 were retrospectively included. All patients underwent 3.0T CMR scan and serum YKL-40 was measured.We used t test, Mann-Whitney U test or chi square test to compare the difference of each index between the myocardial injury group and the non-myocardial injury group; Spearman correlation analysis and linear regression were used to analyze the relationship between serum YKL-40 and CMR parameters in IIM patients. Results:Compared with patients without myocardial injury,IIM patients with myocardial injury had higher age [(53.0 ± 13.0) year vs. (44.6 ± 16.1) year], serum YKL-40 [73.4 (46.9,119.3) ng/mL vs. 48.1 (22.5, 65.1) ng/mL], Native T1 [(1263.2 ± 50.3) ms vs. (1221.8 ± 59.3) ms], and extracellular volume (ECV) [(31.7 ± 5.6)% vs. (28.7 ± 3.2)%], the left ventricular stroke volume index (LVSVI) was lower [(42.3 ± 10.2) mL/m2 vs. (49.0 ± 11.1) mL/m2] (all P<0.05). Serum YKL-40 was positively correlated with ECV (r=0.373, P=0.004). Multiple linear regression analysis showed that serum YKL-40 was independently correlated with ECV. Conclusion:Serum YKL-40 can reflect the degree of myocardial fibrosis in IIM patients with myocardial injury.

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  • 收稿日期:2022-09-18
  • 最后修改日期:2023-03-16
  • 录用日期:2023-08-09
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