患过冠状病毒感染（COVID-19）患者的心脏磁共振成像

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论证。心肌炎是冠状病毒感染（COVID-19）的一种不罕见并发症。

该研究的目的是通过顺磁对比剂增强的心脏磁共振成像，比较患过COVID-19和大流行前患者心肌损伤的不同模式。

材料和方法。一项回顾性研究纳入了47名接受顺磁对比剂增强心脏磁共振成像检查来排除急性心肌炎的患者。第1组包括34名通过鼻咽和/或口咽粘膜涂片聚合酶链反应分析证实曾患过冠状病毒感染的患者，第2组包括13名在冠状病毒大流行（2017年）前接受心脏磁共振成像检查的患者。

结果。从发病到磁共振成像的平均时间为166天。在第一组中，77%的患者运动耐量降低了，分别有14（42%）、30（88%）和28（85%）名患者出现了心脏疼痛、呼吸困难和心悸。在第2组中，有4名患者（30%）出现了呼吸困难，有9名患者（69%）出现了心脏疼痛，有6名患 者（46%）出现了心悸和/或心律不齐。心肌损伤在第1组患者中更为普遍，其中1/3患者有持续性肺强化和胸腔积液。在第1组中，男性的左心室射血分数较低，整体纵向应变较低，左心房功能较高（p<0,05）。对于女性病人来说，仅在左心室心肌受影响节段的数量上存在统计上的差异。

结论。SARS-CoV-2病毒导致广泛的心脏损伤，累及大量心肌节段。对于男性病人来说，更容易出现左心室和左心房收缩功能障碍等炎症后并发症。结果表明，有必要进一步评估COVID-19对心血管系统的长期影响。在这种情况下，带有对比剂的心脏磁共振成像可能是检测心脏损伤严重程度的灵敏成像工具。

作者简介

Aleksandra S. Maksimova

Tomsk National Research Medical Center, Cardiology Research Institute

Email: asmaximova@yandex.ru
ORCID iD: 0000-0002-4871-3283
SPIN 代码: 2879-9550

MD, Cand. Sci. (Med.)

俄罗斯联邦, Tomsk

Nadezhda I. Ryumshina

Tomsk National Research Medical Center, Cardiology Research Institute

编辑信件的主要联系方式.
Email: n.rumshina@list.ru
ORCID iD: 0000-0002-6158-026X
SPIN 代码: 6555-8937

MD, Cand. Sci. (Med.)

俄罗斯联邦, Tomsk

Tatiana A. Shelkovnikova

Tomsk National Research Medical Center, Cardiology Research Institute

Email: fflly@mail.ru
ORCID iD: 0000-0001-8089-2851
SPIN 代码: 1826-7850

MD, Cand. Sci. (Med.)

俄罗斯联邦, Tomsk

Olga V. Mochula

Tomsk National Research Medical Center, Cardiology Research Institute

Email: mochula.olga@gmail.com
ORCID iD: 0000-0002-7502-7502
SPIN 代码: 3712-8492

MD, Cand. Sci. (Med.)

俄罗斯联邦, Tomsk

Nina D. Anfinogenova

Tomsk National Research Medical Center, Cardiology Research Institute

Email: cardio.intl@gmail.com
ORCID iD: 0000-0003-1106-0730
SPIN 代码: 6784-5440

MD, Dr. Sci. (Med.)

俄罗斯联邦, Tomsk

Vladimir Yu. Ussov

Tomsk National Research Medical Center, Cardiology Research Institute

Email: ussov1962@yandex.ru
ORCID iD: 0000-0002-7352-6068
SPIN 代码: 1299-2074

MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Tomsk

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2. 图1。患过COVID-19的一组患者在使用造影剂心脏磁共振成像检查中发现的特征性症状。LGE（late gadolinium enhancement）——心肌延迟强化模式。

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