Page 87 - 南京医科大学学报自然科学版

第43卷第8期 南京医科大学学报（自然科学版）
2023年8月 Journal of Nanjing Medical University（Natural Sciences） ·1121 ·

·临床研究·

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

马珂凡 ，刘王琰 ，王 嫱 ，孙晓萱 ，祝因苏 ，徐 怡 1
2
2
1
1*
1
南京医科大学第一附属医院放射科，风湿科，江苏 南京 210029
1 2
［摘 要］ 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。
［关键词］ 右心室⁃肺动脉耦联；右心室功能；肺动脉高压；心脏磁共振
［中图分类号］ R445.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2023）08⁃1121⁃07
doi：10.7655/NYDXBNS20230812

The study of CMR based right ventricular⁃pulmonary arterial coupling in the assessment
of CTD⁃PH risk stratification

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MA Kefan ，LIU Wangyan ，WANG Qiang ，SUN Xiaoxuan ，ZHU Yinsu ，XU Yi 1
Department of Radiology，Department of Rheumatology，the First Affiliated Hospital of Nanjing Medical University，
1 2
Nanjing 210029，China
［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.
［Key words］ right ventricular⁃pulmonary arterial coupling；right ventricular function；pulmonary hypertension；cardiac magnetic res⁃
onance
［J Nanjing Med Univ，2023，43（08）：1121⁃1127］

［基金项目］ 国家自然科学基金（81601464，61871117）
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通信作者（Corresponding author），E⁃mail：15950536335@163.com