心脏磁共振成像预测酒精性心肌病心力衰竭患者心脏不良事件

目的 探讨心脏磁共振（CMR）心肌对比剂延迟强化（LGE）对酒精性心肌病（ACM）心力衰竭患者心脏不良事件的预测能力。方法 纳入临床诊断为ACM并出现心力衰竭症状的患者58例，对所有患者行CMR，根据是否出现LGE将患者分为LGE（+）组和LGE（-）组。对所有患者进行随访，随访终点定义为发生心脏不良事件，对两组患者随访期间出现的心脏不良事件进行生存分析；将LGE、左心室舒张末期容积、左心室收缩末期容积、左心室射血分数、左心室心肌质量指数、心力衰竭出现时间、饮酒时间纳入多因素Cox比例风险模型，分析心脏不良事件的预测因子。结果 LGE（+）组22例，LGE（-）组36例，共10例发生心脏不良事件，LGE（+）组发生率[31.82%(7/22)]显著高于LGE（-）组[8.33%(3/36),P=0.02]。LGE是心脏不良事件的强预测因子（风险比值：5.74， P=0.02）。结论 CMR心肌LGE是出现心力衰竭症状的ACM患者不良心脏事件的强预测因子。

Cardiac magnetic resonance imaging in predicting cardiac events in alcoholic cardiomyopathy patients with heart failure

Objective To investigate the value of late gadolinium enhancement (LGE) of myocardium in cardiac magnetic resonance imaging (CMR) in predicting cardiac events in alcoholic cardiomyopathy (ACM) patients with heart failure. Method Totally 58 ACM patients with heart failure were enrolled and underwent CMR. According to the CMR, the patients were divided into LGE (+) group and LGE (-) group. All patients were followed up and the occurrence of cardiac events was defined as end point of followed-up. Survival analysis was performed for the cardiac events in followed-up period. Left ventricular end distolic voulume index, left ventricular end systolic volume index, left ventricular ejection fraction, left ventricular myocardial mass index, time of heart failure, drinking history were taken into Cox proportional hazard model to analyze the predictor. Result There were 22 patients in LGE (+) group and 36 patients in LGE (-) group. Cardiac events occurred in 10 cases and the incidence of cardiac events was significantly higher in LGE(+) group (31.82%[7/22]) compared with LGE (-) group (8.33%[3/36], P=0.02). In multivariate analysis, LGE was a strong predictor for cardiac event with hazard ratio of 5.74 (P=0.02). Conclusion In CMR, LGE is a strong predictor for cardiac events in ACM patients with heart failure.