JAHA:院外心脏骤停幸存者早期心脏磁共振检查的心肌水肿预后意义

2021-12-01 MedSci原创 MedSci原创

早期心脏磁共振成像检查明确的ME提示存在急性和短暂致心律失常基础,预测SCA幸存者的长期心律失常结局良好。这些结果可能会对未来SCA幸存者治疗指南产生重大的影响。

心脏骤停(SCA)可能由急性和可逆的心肌损伤、慢性和不可逆的心肌损伤或原发性室性心律失常所致。心脏磁共振成像可以识别心肌水肿(ME),它提示急性和可逆性的心肌损伤。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,在这项研究中,研究人员在随访期间评估了SCA幸存者的心律失常结果,并评估了ME的预后效应。

研究人员纳入了来自9个合作中心的101名(71%为男性,中位年龄为47岁)SCA幸存者,他们接受了早期(<1个月)心脏磁共振成像检查并接受了植入式心律转复除颤器(ICD)。

在T2加权序列中,研究人员发现101名患者中有18名(18%)患者伴有ME。根据心脏磁共振成像检查结果,心律失常性SCA归因于急性心肌损伤(缺血性[n=10]或炎症性[n=8]心肌损伤)、慢性结构性心脏病(缺血性心脏病[n=11]、心肌病[n=20],或其他原因[n=23]),或主要为心律失常综合征(n=29)。在47个月(28至67个月)的随访期间,101名患者中有24名(24%)患者接受了适当的ICD干预治疗。ME与更高的无任何ICD干预(log-rank=0.04)和ICD除颤(log-rank=0.03)生存率显著相关,并且在调整左心室射血分数和晚期钆检查后仍然是心律失常结局较好的独立预测因子。适当的ICD干预的风险与潜在心脏病的类型无关。

由此可见,早期心脏磁共振成像检查明确的ME提示存在急性和短暂致心律失常基础,预测SCA幸存者的长期心律失常结局良好。这些结果可能会对未来SCA幸存者治疗指南产生重大的影响。

原始出处:

Alessandro Zorzi,et al.Prognostic Role of Myocardial Edema as Evidenced by Early Cardiac Magnetic Resonance in Survivors of Out‐of‐Hospital Cardiac Arrest: A Multicenter Study.JAHA.2021.https://www.ahajournals.org/doi/10.1161/JAHA.121.021861

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    2021-12-03 zhaohui6731
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    2021-12-03 小华子
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1268701, encodeId=c6431268e0121, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Fri Dec 03 00:36:04 CST 2021, time=2021-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1305681, encodeId=fd9a1305681f2, content=<a href='/topic/show?id=1787983537c' target=_blank style='color:#2F92EE;'>#院外心脏骤停#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98353, encryptionId=1787983537c, topicName=院外心脏骤停)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b96f328, createdName=wwzzly, createdTime=Fri Dec 03 00:36:04 CST 2021, time=2021-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333501, encodeId=83bc133350120, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Fri Dec 03 00:36:04 CST 2021, time=2021-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341752, encodeId=81ec1341e5210, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Fri Dec 03 00:36:04 CST 2021, time=2021-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401472, encodeId=307a14014e203, content=<a href='/topic/show?id=c818516291b' target=_blank style='color:#2F92EE;'>#心脏磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=51629, encryptionId=c818516291b, topicName=心脏磁共振)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3f342339746, createdName=mhzhuang@stu.e, createdTime=Fri Dec 03 00:36:04 CST 2021, time=2021-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1486099, encodeId=ad37148609941, content=<a href='/topic/show?id=e633e37655a' target=_blank style='color:#2F92EE;'>#磁共振检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73765, encryptionId=e633e37655a, topicName=磁共振检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c61d8077813, createdName=12498ef1m33(暂无昵称), createdTime=Fri Dec 03 00:36:04 CST 2021, time=2021-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1546264, encodeId=59a6154626464, content=<a href='/topic/show?id=a6fa100185d7' target=_blank style='color:#2F92EE;'>#预后意义#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100185, encryptionId=a6fa100185d7, topicName=预后意义)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ba9d13903217, createdName=haouestc, createdTime=Fri Dec 03 00:36:04 CST 2021, time=2021-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075821, encodeId=dfc010e5821aa, content=👍🏻, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a73e6157669, createdName=ms4000000371457116, createdTime=Wed Dec 01 11:29:45 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1075804, encodeId=c91310e580489, content=👍👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5c215443174, createdName=ms2000001126767624, createdTime=Wed Dec 01 10:53:45 CST 2021, time=2021-12-01, status=1, ipAttribution=)]
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    2021-12-01 ms4000000371457116

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    2021-12-01 ms2000001126767624

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