采用CMR定量心肌灌注技术评价心肌微循环障碍在射血分数保留心衰发生机制中的作用

Heart failure (HF) is a major cause of cardiovascular death. The heart failure preserved ejection fraction (HFpEF) accounted for 50% of overall HF, which induced by abnormal ventricular diastolic function while systolic function is still retained. However, the mechanism of HFpEF remained unknown, so there is no effective treatment. Myocardial microcirculation disorder (MVD), left ventricular diffused fibrosis may contribute the injury of diastolic function, but has not been confirmed. Our team found that CMR quantitative myocardial perfusion technique could evaluate the MVD, ventricular diastolic function decreased in patients with MVD, and through the rabbit model of metabolic syndrome, we found that the reduction of ventricular diastolic function was correlated with diffused fibrosis. We proposed to establish a HFpEF rat model, using the CMR quantitative myocardial perfusion technique analysis, analyze the relationship between MVD, myocardial endothelial inflammatory infiltrates, diffused myocardial fibrosis and the reduction of ventricular diastolic function by CMR. Trying to clarify the role of MVD in the occurrence mechanism of HFpEF. Then provide the fundamental knowledge for further clinical studies of HFpEF. Evaluating the relationship between MVD, blood biomarker, symptom and the diastolic function in patients with HFpEF. MVD boundary value, and its application in diagnosis, illness evaluation and prognosis in patients with HFpEF.

心力衰竭（HF）是心血管病死亡主要原因之一。其中射血分数保留心衰（HFpEF）占总体心衰的50%，为心室舒张功能异常引起HF表现，而收缩功能尚保留。因其发生机制不明，因此无有效治疗手段。近期研究显示，心肌微循环障碍（MVD），进而引起左室弥漫性纤维化，可能为其发生机制，但尚未得到证实。本课题组前期研究显示CMR定量心肌灌注技术可评价心肌MVD，心肌MVD患者常伴有心室舒张功能减低，并通过代谢综合症兔模型研究发现心肌舒张功能减低和心肌弥漫性纤维化程度相关。进一步拟建立大鼠HFpEF模型，采用CMR定量心肌灌注技术分析心肌MVD，并分析其与血管内皮炎性浸润、弥漫心肌纤维化及心室舒张功能减低之间的关系，阐明心肌MVD在HFpEF发生机制中的作用，为HFpEF的进一步临床研究提供依据。并进行HFpEF临床患者MVD研究，进一步为HFpEF诊断、病情评估、预后评价提供依据。

心力衰竭（HF）是心血管病死亡主要原因之一。其中射血分数保留心衰（HFpEF）占总体心衰的50%，为心室舒张功能异常引起HF表现，而收缩功能尚保留。因其发生机制不明，因此无有效治疗手段。近期研究显示，心肌微循环障碍（MVD），进而引起左室弥漫性纤维化，可能为其发生机制，但尚未得到证实。本课题组前期研究显示CMR定量心肌灌注技术可评价心肌MVD，心肌MVD患者常伴有心室舒张功能减低，并通过代谢综合症兔模型研究发现心肌舒张功能减低和心肌弥漫性纤维化程度相关。进一步拟建立大鼠HFpEF模型，采用CMR定量心肌灌注技术分析心肌MVD，并分析其与血管内皮炎性浸润、弥漫心肌纤维化及心室舒张功能减低之间的关系，阐明心肌MVD在HFpEF发生机制中的作用，为HFpEF的进一步临床研究提供依据。并进行HFpEF临床患者MVD研究，进一步为HFpEF诊断、病情评估、预后评价提供依据。