Myocardial fibrosis-related factors in patients with hypertrophic cardiomyopathy / 中国基层医药

ABSTRACT

Objective:To investigate myocardial fibrosis-related factors in patients with hypertrophic cardiomyopathy.Methods:Ninety-six patients with hypertrophic cardiomyopathy who received treatment in Zhoushan Hospital between January 2019 and January 2021 were included in this study. General data of all patients were collected. Cardiovascular magnetic resonance imaging was performed in all patients. Percentage of late gadolinium enhancement (LGE) was calculated. These patients were divided into positive and negative groups according to whether myocardial fibrosis existed. Related parameters were compared between the two groups. Correlations between related parameters and myocardial fibrosis range were analyzed.Results:Patient age in the positive group was significantly lower than that in the negative group [(42.84 ± 14.38) years vs. (50.71 ± 14.74) years, t = 2.04, P < 0.05]. The percentage of patients with New York Heart Association (NYHA) class III/IV heart function, N-terminal pro-brain natriuretic peptide (NT-proBNP) level, cardiac troponin (cTnI) level, creatine kinase-MB level, and myoglobin level in the positive group were 29.41% (20/68), 2 761.73 (1 505.22, 3 784.62) ng/L, 0.971 (0.447, 1.687) μg/L, (3.25 ± 2.65) μg/L and (66.14 ± 31.17) μg/L, respectively, which were significantly higher than those in the negative group [3.57% (1/68), 862.35 (551.48, 1 094.83) ng/L, 0.146 (0.037, 0.256) μg/L, (0.73 ± 0.22) μg/L, (28.82 ± 2.34) μg/L, t = 12.17, 55.28, 3.17, 5.18, 8.18, all P < 0.05]. Left ventricular ejection fraction and cardiac index in the positive group were (62.31 ± 17.89)% and (2.85 ± 0.71) L·min -1·(m 2) -1, respectively, which were significantly lower than those in the negative group ( t = 2.89, 6.18, both P < 0.05). Left ventricular end-diastolic volume (LVEDV), left ventricular maximum wall thickness (LVMWT) and left ventricular mass index (LVMI) in the positive group were (56.32 ± 17.28) mL/m 2, (2.24 ± 0.41) cm, (126.15 ± 12.34) g/m 2, which were significantly higher than those in the negative group ( t = 2.17, 2.75, 13.10, all P < 0.05). In the positive group, 18 patients had moderate and severe hypertrophy, 20 patients had moderate hypertrophy, and 30 patients had mild hypertrophy. There were significant differences in NT-proBNP, cTnI level and (LGE) extent between positive and negative groups ( t = 43.27, 5.28, 11.18, all P < 0.05). NT-proBNP, cTnI level and LGE extent increased with the increase in hypertrophy. Percentage of LGE was negatively correlated with patient age, and it was positively correlated with NT-proBNP, cTnI, LVDSV, LVMWT and LVMI. The differences were statistically significant (all P < 0.05). Conclusion:Patients with hypertrophic cardiomyopathy have a relatively high incidence of myocardial fibrosis. The extent of myocardial fibrosis is negatively correlated with patient age and it is positively correlated with NT-proBNP, cTnI, LVDSV, LVMWT and LVMI.