| 王玲,鲁国卫,章宏,等.2型糖尿病老年病人心肌纤维化 T1-Mapping与左心室应变参数的相关性分析[J].安徽医药,2024,28(9):1866-1870. |
| 2型糖尿病老年病人心肌纤维化 T1-Mapping与左心室应变参数的相关性分析 |
| Correlation between T1-mapping of myocardial fibrosis and left ventricular strain parameters in elderly patients with type 2 diabetes mellitus |
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| DOI：10.3969/j.issn.1009-6469.2024.09.037 |
| 中文关键词: 糖尿病， 2型 心脏磁共振 心肌纤维化 心肌应变 T1-Mapping参数 |
| 英文关键词: Diabetes mellitus, type 2 Cardiac magnetic resonance Myocardial fibrosis Myocardial strain T1-mapping parameter |
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| 中文摘要: |
| 目的探究 2型糖尿病( T2DM)老年病人心肌纤维化 T1-Mapping参数与左心室应变参数之间的相关性。方法以 2019年 8月至 2022年 8月在孝感市中心医院就诊的 T2DM病人 82例为研究对象，根据病人的病程分为短期 T2DM组 40例(病程 <5年)和长期 T2DM组 42例(病程 ≥5年)，以同期招募的健康志愿者 40例为对照组。比较各组间左心室应变参数及 T1-Mapping参数。采用多元线性逐步回归法分析 T1-Mapping参数的影响因素。采用相关性分析 T1-Mapping参数与左心室应变参数的相关性。结果短期 T2DM组病人左室周向峰值舒张应变率( PDSR)［1.25(0.95，1.50)1/s比 1.40(1.20，1.70)1/s］较对照组降低( P< 0.05)细胞外体积( ECV)［31.00(29.00，33.50)%比 29.00(27.00，32.00)%］较对照组升高( P<0.05)。与对照组比较，长期 T2DM组病人左，室纵向峰值应变( PS)［-14.50(-12.38，-16.50)%比-16.15(-14.60，-18.30)%］、径向 PDSR［(-2.58±0.83)1/s比(-3.32± 0.88)1/s］、周向 PDSR［0.90(0.70，1.20)1/s比 1.40(1.20，1.70)1/s］、纵向 PDSR［0.70(0.58，0.90)1/s比 1.10(0.80，1.38)1/s］降低( P <0.05)ECV［34.00(32.00，35.00)%比 29.00(27.00，32.00)%］升高( P<0.05)。与短期 T2DM组比较，长期 T2DM组病人左室纵向 PS［-14.5，0(-12.38，-16.50)%比-16.15(-14.45，-18.38)%］、径向 PDSR［( -2.58±0.83)1/s比( -3.61±0.76)1/s］、周向 PDSR［0.90(0.70，1.20)1/s比 1.25(0.95，1.50)1/s］、纵向 PDSR［0.70(0.58，0.90)1/s比 1.10(0.80，1.30)1/s］降低( P<0.05)，ECV［34.00(32.00， 35.00)%比 31.00(29.00，33.50)%］升高( P<0.05)。多元线性回归分析结果示，糖尿病病程是 T2DM病人 ECV的独立影响因素(β=0.29，P<0.05)。 Spearman相关性分析结果示， T2DM病人 ECV与左室纵向 PS(r=0.35，P<0.05)、纵向峰值收缩应变率(PSSR)(rs=0.31，P<0.05)呈显著正相关，与左室周向 PDSR(rs=-0.29，P<0.05)、纵向 PDSR(rs=-0.43，P<0.05)呈显著负相关。结论心脏磁共振 T1-Mapping可能发现 T2DM病人早期心肌纤维化， T1-Mapping参数与左心室应变参数显著相关。 |
| 英文摘要: |
| Objective To explore the correlation between T1-mapping parameters and left ventricular strain parameters of myocardialfibrosis in elderly patients with type 2 diabetes mellitus (T2DM).Methods A total of 82 T2DM patients who were treated at XiaoganCentral Hospital from August 2019 to August 2022 were selected as the research subjects. According to the disease duration of the pa-tients, they were divided into 40 patients in the short-term T2DM group (disease duration < 5 years) and 42 patients in the long-term T2DM group (disease duration ≥ 5 years), and 40 healthy volunteers recruited during the same period composed the control group. Theleft ventricular strain parameters and T1-mapping parameters were compared between the groups. A multivariate linear stepwise regres-sion method was used to analyze the influencing factors of the T1-mapping parameters. The correlation between T1-mapping parameters and left ventricular strain parameters was analyzed using correlation analysis.Results Compared with patients in the control group, pa- tients in the short-term T2DM group had a lower left ventricular circumferential peak diastolic strain rate (PDSR) [1.25 (0.95, 1.50) 1/s vs. 1.40 (1.20, 1.70) 1/s] (P < 0.05), and greater extracellular volume (ECV) [31.00 (29.00, 33.50) % vs. 29.00 (27.00, 32.00) %] (P < 0.05). Compared with those in the control group, patients in the long-term T2DM group had greater left ventricular longitudinal peak strain (PS) [-14.50 (-12.38, -16.50) % vs. -16.15 (-14.60. -18.30) %], radial PDSR [(-2.58±0.83) 1/s vs. (-3.32±0.88) 1/s], circumfer- ential PDSR [0.90 (0.70, 1.20) 1/s vs. 1.40 (1.20, 1.70) 1/s], and longitudinal PDSR [0.70 (0.58, 0.90) 1/s vs. 1.10 (0.80, 1.38) 1/s] were lower (P<0.05), and ECV [34.00 (32.00, 35.00) % vs. 29.00 (27.00, 32.00) %] was greater (P<0.05). Compared with those in the short-term T2DM group, patients in the long-term T2DM group had greater left ventricular longitudinal PS [-14.50 (-12.38, -16.50) % vs.-16.15 (-14.45. -18.38) %], radial PDSR [(-2.58±0.83) 1/s vs. (-3.61±0.76) 1/s], circumferential PDSR [0.90 (0.70, 1.20) 1/s vs. 1.25 (0.95, 1.50) 1/s], and longitudinal PDSR [0.70 (0.58, 0.90) 1/s vs. 1.10 (0.80, 1.30) 1/s] decreased (P<0.05), and ECV [34.00 (32.00, 35.00) % vs. 31.00 (29.00, 33.50) %] increased (P<0.05). Multivariate linear regression analysis revealed that the duration of diabetesmellitus had an independent influence on the ECV in patients with T2DM (β=0.29, P<0.05). Spearman correlation analysis revealedthat the ECV in patients with T2DM was significantly positively correlated with longitudinal left ventricular PS (r=0.35, P<0.05) and slongitudinal peak systolic strain rate (PSSR) (rs=0.31, P<0.05), and significantly negatively correlated with the LV circumferential PD- SR (r=-0.29, P<0.05) and longitudinal PDSR (r=-0.43, P<0.05), respectively.Conclusion Cardiac magnetic resonance T1-mappingss may detect early myocardial fibrosis in T2DM patients, and T1-mapping parameters were significantly correlated with left ventricular strain parameters. |
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