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目的初探肥厚性心肌病(HCM)心肌 MR 延迟增强(DE)与心肌钙蛋白Ⅰ(cTn Ⅰ)的相关性,以及二者联合用于评价 HCM 病情和提示预后的价值。方法搜集经超声心动图诊断的HCM 患者35例,均同期行 MR 检查和血 cTn Ⅰ检测,分析 MR 延迟增强与心肌肥厚、cTn Ⅰ值改变的关系。结果(1)35例 HCM 中出现 MR 心肌灌注延迟期强化者25例(71.4%),血 cTn Ⅰ异常增高者19例。无 DE 组 cTn Ⅰ中位值5μg/L,DE 组 cTn Ⅰ中位值110μg/L,2组之间差异有统计学意义(U=-2.618,P<0.05)。DE 组25例中有18例(72.0%)血 cTn Ⅰ异常增高,而在19例血 cTn Ⅰ异常增高者中18例(94.7%)出现延迟强化。(2)心肌增强比例与肥厚比例呈正相关(r_s=0.713,P<0.01)。cTn Ⅰ值与心肌肥厚比例、增强比例呈正相关(r_s=0.521、0.605,P 均<0.01)。结论心肌MRI 延迟增强和血 cTn Ⅰ异常升高常同时发生于 HCM 患者。MR 心肌延迟强化成像与 cTn Ⅰ检测联合应用可以为准确判断 HCM 病情、评价疗效及预后提供有效的信息。
Objective To investigate the correlation between delayed myocardial MR (DE) and cardiac troponin Ⅰ (cTn Ⅰ) in patients with hypertrophic cardiomyopathy (HCM) and the value of combination of the two in the evaluation of HCM and prognosis. Methods Totally 35 HCM patients diagnosed by echocardiography were collected. MR examination and cTn Ⅰ detection were performed in the same period. The relationship between MR delay enhancement and cardiac hypertrophy and cTn Ⅰ was analyzed. Results (1) Among the 35 patients with HCM, 25 cases (71.4%) had delayed enhancement of myocardial perfusion and 19 cases had abnormal blood cTn Ⅰ. The median of cTn Ⅰ was 5μg / L in DE group and 110μg / L cTn Ⅰ in DE group. There was significant difference between the two groups (U = -2.618, P <0.05). 18 cases (72.0%) of 25 cases in DE group had abnormal increase of cTn Ⅰ, while 18 cases (94.7%) of 19 cases had abnormal increase of cTn Ⅰ. (2) The ratio of myocardial enhancement was positively correlated with the proportion of hypertrophy (r_s = 0.713, P <0.01). There was a positive correlation between cTn Ⅰ and myocardial hypertrophy (r_s = 0.521,0.605, P <0.01). Conclusion Myocardial MRI delayed enhancement and elevated blood cTn Ⅰ often occur in HCM patients. Combined application of delayed myocardial MR imaging and cTn Ⅰ detection can provide effective information for accurate judgment of HCM status, evaluation of curative effect and prognosis.