致心律不齐性右心室型心肌病患者右心室室壁脂肪浸润或纤维化程度与右心室功能及容积的相关性

摘要

Objective To investigate the correlation of right ventricular wall fatty infiltration or fibrosis degree and function and volume of right ventricle in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC).Methods Twenty ARVC patients were enrolled.Multi-sequences of MR scanning were performed,and the transverse diameter of outflow tract of right and left ventricle,end-diastolic dimension (EDD),ejection fraction (EF),end-diastolic volume index (EDVI),end-systolic volume index (ESVI),cardiac output index (CI),as well as right ventricular myocardial mass index (MASSI) and fat and fibrosis tissue characteristics were quantitatively evaluated.The correlation between right ventricular wall fatty infiltration or fibrosis and right ventricular function and volume were analyzed.Results The right ventricular outflow tract transverse diameter was (52.42±11.80)mm,and right ventricular EDD,EF,EDVI,ESVI,CI and MASSI was(50.13 ± 8.71) mm,(18.13± 6.71)％,(169.13 ± 72.11) ml/m2,(117.01 ± 67.31) ml/m2,(1.81±0.20) L/(min · m2) and (17.62 ±1.80)ml/m2,respectively.The right ventricular free wall/anterior wall involvement was observed in all 20 cases,while inferior wall involvement,apical involvement and right ventricular outflow tract involvement was noticed in 10,14 and 15 cases,respectively.The right ventricular wall fat infiltration or fibrosis index was (70.00±22.33) ％,correlated with right ventricular EF (r=-0.627,P =0.003),EDVI (r=0.695,P=0.001)) and ESVI (r=0.676,P=0.001).Conclusion The correlation of right ventricular wall fatty infiltration or fibrosis degree and function and volume of right ventricle may reflect changes of cardiac function in ARVC patients.%目的 探讨致心律不齐性右心室型心肌病(ARVC)患者右心室室壁脂肪浸润或纤维化程度与右心室功能及容积的相关性.方法 对20例ARVC患者行多序列MR扫描,测量左右心室流出道横径、左右心室舒张末横径(EDD)、左右心室射血分数(EF)、左右心室舒张末容积指数(EDVI)、左右心室收缩末容积指数(ESVI)、左右心室心输出量指数(CI)、右心室心肌质量指数(MASSI)及室壁脂肪浸润或纤维化程度情况,采用线性相关分析观察右心室室壁脂肪浸润或纤维化程度与右心室功能及容积的相关性.结果 ARVC患者右心室流出道横径(52.42±11.80)mm,右心室EDD、EF、EDVI、ESVI、CI、MASSI分别为(50.13±8.71)mm、(18.13±6.71)％、(169.13±72.11) ml/m2、(117.01±67.31) ml/m2、(1.81±0.20)L/(min·m2)、(17.62±1.80)g/m2.20例右心室游离壁/前壁均受累,10例下壁受累,14例心尖部受累,15例右心室流出道受累;右心室室壁脂肪浸润或纤维化指数(70.00±22.33)％,与右心室EF值呈负相关(r=-0.627,P=0.003),与右心室EDVI(r=0.695,P=0.001)和ESVI均呈正相关(r=0.676,P=0.001).结论 右心室室壁脂肪浸润或纤维化程度与右心室功能及容积的相关性可反映ARVC患者心脏功能变化.