| Objective: The purpose of this study was to evaluate the association between malignant ventricular arrhythmias and delayed enhancement of cardiac magnetic resonance contrast agents in Chinese han Chinese patients with dilated cardiomyopathy.Methods: This study collected 52 inpatients diagnosed with dilated cardiomyopathy(DCM)from the First People's Hospital of Chenzhou City,Nanhua University from October 2017 to January 2020.The LGE obtained by analyzing CMR(LGE is defined as the analysis of the performance of abnormal myocardial signal and normal myocardial signal intensity difference greater than 2 standard deviations on the same shortaxis plane.They are divided into LGE(+)group(with delayed enhancement)and 34 cases,and LGE(-)group(no Delayed strengthening)18cases.According to the LOWN classification criteria for the severity of premature ventricular premature beats(grades 0-5,of which grades 3-5are malignant ventricular arrhythmias),a comparative analysis of mali-gnant ventricular arrhythmias in the LGE(+)group and the LGE(-)group was performed.The number of segments involved in myocardial fibrosis in the LGE(+)group was classified according to the 17-segment myocardial method of the American Heart Association: 0 to 2,3 to 5,and6 or more;through the left ventricular short-axis plane The cumulative area of LGE(+)as a percentage of left ventricular myocardial area represents the severity of myocardial fibrosis,that is,mild(1 to 25%),moderate(25 to 50%),and severe(> 50%).Statistical analysis was performed using spss23.0 statistical software.Results: 1.Malignant ventricular arrhythmias occurred in 21 of the34 cases in the LGE(+)group(21/34,61.76%);malignant ventricular arrhythmias occurred in 4 of the 18 cases in the LGE(-)group(4/18,22.22%),the rate of malignant ventricular arrhythmias in the LGE(+)group was higher than that in the LGE(-)group,the difference was statistically significant(P < 0.05),and the risk of malignant ventricular arrhythmias in LGE(+)It is significantly higher than LGE(-),up to 4.65 times [95% CI(0.360,2.034)].2.According to the severity of myocardial fibrosis in the LGE(+)group: Mild: 4 cases,no malignant ventricular arrhythmia occurred;Moderate: 21 cases,14 cases had malignant ventricular arrhythmia;Severe: In9 cases,7 cases had malignant ventricular arrhythmias.The results showed that the severity of LGE(+)was significantly correlated with the occu-rrence of malignant ventricular arrhythmias,and the difference was stati-stically significant(P <0.05),and there was a positive correlation.3.34 patients in the LGE(+)group were classified according to the number of myocardial segments involved in myocardial fibrosis: 0 to 2myocardial segments were involved: 6 cases,1 case had malignant ventricular arrhythmias;3 to 5 cases were involved Myocardial segment: 19 cases,13 cases had malignant ventricular arrhythmia;involved ? 6 myocardial segments: 9 cases,7 cases had malignant ventricular arrhythmia.The number of different myocardial segments involved and the incidence of malignant ventricular arrhythmias were statistically significant(P<0.05);and the risk of malignant ventricular arrhythmias involving 3 to 5segments was significantly higher than that involving 0 to 2 Segment,up to 3.66 times [95% CI(0.243,1.137)];the risk of malignant ventricular arrhythmia involving 6 or more segments is significantly higher than 3 to5 segments,up to 2.61 times [95% CI(1.137),4.105)].4.The distribution of myocardial fibrosis in the LGE(+)group is shown in Table 5.It occurred in the basal segment(anterior partition wall,inferior partition wall,inferior wall),the middle segment(anterior partition wall,inferior wall),and the apical segment(particular wall,inferior wall).apical cap,these segments' RR values are significantly greater than other segments,and there is a significant difference between the occurrence of malignant ventricular arrhythmia,P <0.05;and occurred in thebasal segment(anterior wall,side wall,anterior side)Wall),middle section(inferior wall,inferior wall,anterior wall),apical section(front wall,lateral wall)and the occurrence of malignant ventricular arrhythmias(P>0.05).It shows that the involvement of LGE(+)segment in dilated cardiomyopathy is significantly related to the occurrence of malignant ventricular arrhythmias.Conclusion: Myocardial fibrosis in patients with dilated cardiomyopathy has a certain correlation with the occurrence of malignant ventricular arrhythmia;the number and severity of LGE(+)segments are positively correlated with the occurrence of malignant ventricular arrhythmia;The risk of developing malignant ventricular arrhythmias is higher. |
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