摘要目的:探讨心脏磁共振特征衍生的左心房应变参数对慢性肾脏病（CKD）患者合并射血分数保留型心力衰竭（HFpEF）的预测价值。方法:回顾性分析2020年5月至2024年1月西安凤城医院接收的130例CKD合并HFpEF患者，纳入观察组，其中男82例，女48例，年龄（46.97±10.21）岁；另选取同期100例CKD患者纳入对照组，其中男60例，女40例，年龄（48.02±11.67）岁。两组患者均行心脏磁共振成像、MRI斑点追踪分析检测获取左心房僵硬指数（LASI）、左心房充盈指数（LAFI）等指标，收集两组一般资料，采用Pearson相关性分析评估LASI、LAFI与心肌肌钙蛋白T（cTnT）、N末端脑钠肽前体（NT-proBNP）水平的相关性，并通过受试者操作特征曲线（ROC）评估LASI、LAFI对CKD患者合并HFpEF的预测价值。采用 χ2检验、独立样本 t检验、秩和检验进行统计学分析。 结果:两组在收缩压、舒张压、高血压、糖尿病、cTnT、NT-proBNP、尿素、肌酐、估算肾小球滤过率（eGFR）方面差异均有统计学意义（均 P<0.05）。观察组LASI、LAFI高于对照组［0.66（0.44，0.94）比0.21（0.16，0.31），2.95（1.89，4.78）比1.75（1.32，2.10）］，差异均有统计学意义（ Z=11.615、7.326，均 P<0.05）。相关性分析结果显示：LASI、LAFI与cTnT、NT-proBNP水平均呈正相关（均 P<0.05）。ROC分析结果显示：LASI、LAFI预测CKD患者合并HFpEF的曲线下面积分别为0.947、0.782。 结论:心脏磁共振特征衍生的左心房应变参数LASI与LAFI在CKD患者合并HFpEF的评估中有预测价值。

abstractsObjective:To investigate the predictive values of cardiac MRI-derived left atrial strain parameters for heart failure with preserved ejection fraction (HFpEF) in patients with chronic kidney disease (CKD).Methods:A retrospective analysis was conducted on 130 patients with CKD and HFpEF admitted to Xi'an Fengcheng Hospital from May 2020 to January 2024, who were included in the observation group, including 82 males and 48 females, with an age of (46.97±10.21) years old. Another 100 patients with CKD during the same period were selected and included in the control group, including 60 males and 40 females, with an age of (48.02±11.67) years old. Both groups underwent cardiac MRI and MRI speckle tracking analysis to obtain indicators such as left atrial stiffness index (LASI) and left atrial filling index (LAFI). The general data of both groups were collected. Pearson correlation analysis was used to evaluate the correlations between LASI, LAFI and the levels of cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). The predictive values of LASI and LAFI for HFpEF in CKD patients were assessed through the receiver operating characteristic curve (ROC). Statistical analysis was conducted using the χ2 test, independent sample ttest, and rank sum test. Results:There were statistically significant differences between the two groups in terms of systolic blood pressure, diastolic blood pressure, hypertension, diabetes, cTnT, NT-proBNP, urea, creatinine, and estimated glomerular filtration rate (eGFR) (all P<0.05). The LASI and LAFI values in the observation group were higher than those in the control group [0.66 (0.44, 0.94) vs. 0.21 (0.16, 0.31), 2.95 (1.89, 4.78) vs. 1.75 (1.32, 2.10)], with statistically significant differences ( Z = 11.615 and 7.326, both P<0.05). The correlation analysis results showed that LASI and LAFI were positively correlated with the levels of cTnT and NT-proBNP (all P<0.05). The ROC analysis results showed that the areas under the curves of LASI and LAFI in predicting the presence of HFpEF in CKD patients were 0.947 and 0.782, respectively. Conclusion:Cardiac MRI-derived left atrial strain parameters, LASI and LAFI, have predictive values in assessing HFpEF in CKD patients.