Correlation Between Myocardial Fibrosis And NT-proBNP And Hcy In Patients With Cardiomyopathy

Objective: To investigate the association between myocardial fibrosis evaluated by delayed enhancement of cardiac magnetic resonance gadolinium contrast agent(LGE-MRI)with NT-proBNP,homocysteine in patients with cardiomyopathy.Methods: The clinical data of patients with cardiomyopathy who were hospitalized in Hunan Provincial people’s Hospital from September 1,2016 to February 10,2019 were analyzed retrospectively.the clinical data of cardiomyopathy patients with cardiac magnetic resonance and color Doppler ultrasound were improved in the same period.According to the enhancement of cardiac magnetic resonance gadolinium delayed imaging,the patients were divided into LGE positive group(n=31)and LGE negative group(n=24).The clinical data of the two groups were compared,such as age,left ventricular ejection fraction(LVEF),homocysteine(Hcy),NT-proBNP and so on.At the same time,the cardiac color Doppler ultrasound parameters of patients with dilated cardiomyopathy and hypertrophic cardiomyopathy in LGE positive group and LGE negative group were compared,and the correlation between cardiac color Doppler ultrasound parameters and the severity of LGE and NT-proBNP was analyzed.Results:1.LGE positive was observed in 31 of 55 patients with cardiomyopathy.The age of patients with cardiomyopathy in LGEpositive group was significantly older than thoses of LGE negative group(p<0.05).NT-proBNP,homocysteine in patients with cardiomyopathy in LGE positive group was significantly higher than thoses of LGE negative group(p<0.05).The left ventricular ejection fraction of patients with cardiomyopathy in LGE positive group was significantly lower than thoses of the LGE negative group(p<0.05).The age of patients with cardiomyopathy in LGE positive group was positively correlated with the severity of LGE(r=0.379,p<0.05).2.Multivariate logistics regression analysis showed that homocysteine(OR=1.34,p=0.01)、 NT-proBNP(OR=1.00,p=0.01)、LVEF(OR=0.93,p=0.01)and age(OR=1.10,p=0.03)were independent predictors for LGE positive in patients with cardiomyopathy.3.There were 25 patients with dilated cardiomyopathy in 55 patients with cardiomyopathy,LGE positive was observed in 12 of 25 patients with dilated cardiomyopathy.The left ventricular anterior and posterior diameters of patients with dilated cardiomyopathy in LGE positive group was larger than thoses of LGE negative group(p<0.05).The left ventricular ejection fraction(LVEF)of patients with dilated cardiomyopathy in LGE positive group was significantly lower than thoses of LGE negative group(p<0.05).4.There were 30 patients with hypertrophic cardiomyopathy in 55 patients with cardiomyopathy,LGE positive was observed in 19 of 30 patientswith hypertrophic cardiomyopathy.The maximum wall thickness of patients with hypertrophic cardiomyopathy in LGE positive group was larger than thoses of LGE negative group,and the difference was statistically significant(p<0.05).The maximum wall thickness was positively correlated with the severity of cardiac LGE in patients with hypertrophic cardiomyopathy(r=0.613,p<0.05).Conclusion: 1.Cardiomyopathy patients with myocardial fibrosis were strongly evaluated by cardiac magnetic resonance gadolinium contrast agent.It was observed that LGE positive group had elevated NT-proBNP,elevated homocysteine level,older age,and lower left ventricular ejection fraction.2.The left ventricular anterior and posterior diameter and left ventricular ejection fraction(LVEF)of LGE positive group were larger and left ventricular ejection fraction(LVEF)was lower than thoses of LGE negative group in patients with dilated cardiomyopathy.3.The maximum wall thickness of LGE positive group was larger than that of LGE negative group in patients with hypertrophic cardiomyopathy.The maximum wall thickness was positively correlated with the severity of cardiac LGE.