目的:我们旨在对心电图(ECG)进行全面分析,二维超声心动图(2DE),和SSc患者的心脏磁共振成像(CMR)发现;还研究了CMR发现与某些ECG和超声心动图(ECHO)结果之间的相关性。
方法:我们回顾性分析了在我们的门诊转诊中心定期就诊的SSc患者的数据,所有用心电图评估,多普勒超声心动图,和CMR。
结果:包括93例患者;平均(S.D.)年龄为48.5(10.3)岁,86%女性,51%弥漫性SSc。84例(90.3%)患者有窦性心律。最常见的心电图发现是左前分支传导阻滞,26例(28%)。超声心动图检查发现43例(46.2%)患者的间隔异常运动(ASM)。心肌受累(炎症或纤维化),通过多参数CMR评估,存在于>50%的患者中。年龄-性别调整模型显示,ECHO上的ASM显着增加了细胞外体积(ECV)的几率(OR:4.43,95CI:1.73-11.38);T1松弛时间增加(OR:2.67,95CI:1.09-6.54);T2松弛时间增加(OR:2.56,95CI:1.05-6.22);T2加权成像中信号强度比增加(OR:2.9556-6.56,存在晚期钆增强(LGE)(OR:3.85,95CI:1.52-9.76)和中壁纤维化(OR:3.64,95CI:1.48-8.96)。
结论:这项研究表明,ECHO中ASM的存在是SSc患者CMR异常的预测因子,对ASM的精确评估可能是选择应由CMR评估以早期发现心肌受累的患者的重要点。
OBJECTIVE: We aimed to perform a comprehensive analysis of the ECG, two-dimensional echocardiography (2DE) and cardiac MRI (CMR) findings in patients with systemic sclerosis (SSc), and also to investigate correlations between CMR findings and some ECG and echocardiography (ECHO) results.
METHODS: We retrospectively analysed data from patients with SSc who were regularly seen at our outpatient referral centre, all assessed with ECG, Doppler ECHO and CMR.
RESULTS: Ninety-three patients were included; mean (s.d.) age of 48.5 (10.3) years, 86% female, 52% diffuse SSc. Eighty-four (90%) of the patients had sinus rhythm. The most common ECG finding was the left anterior fascicular block, recorded in 26 patients (28%). The abnormal septal motion (ASM) was found in 43 (46%) patients on ECHO. Myocardial involvement (inflammation or fibrosis), as assessed by multiparametric CMR, was present in >50% of our patients. The age- and sex-adjusted model showed that ASM on ECHO increased significantly the odds of increased extracellular volume [odds ratio (OR) 4.43, 95% CI 1.73, 11.38], increased T1 Relaxation time (OR 2.67, 95% CI 1.09, 6.54), increased T2 Relaxation time (OR 2.56, 95% CI 1.05, 6.22), increased signal intensity ratio in T2-weighted imaging (OR 2.56, 95% CI 1.05, 6.22), presence of late gadolinium enhancement (OR 3.85, 95% CI 1.52, 9.76) and mid-wall fibrosis (OR 3.64, 95% CI 1.48, 8.96).
CONCLUSIONS: This study indicates that the presence of ASM on ECHO is a predictor of abnormal CMR in SSc patients, and a precise assessment of ASM may serve as an important point for selecting the patients that should be evaluated by CMR for early detection of myocardial involvement.