上海交通大学学报（医学版）2026，Vol.46Issue(3)：322-331,10.DOI:10.3969/j.issn.1674-8115.2026.03.006
心脏磁共振对COVID-19轻症患者心肌损伤的诊断价值
Diagnostic value of cardiac magnetic resonance for myocardial injury in patients with mild COVID-19 infection
摘要
Abstract
Objective·To establish a cardiac magnetic resonance(CMR)-based diagnostic model for detecting myocardial injury in patients with mild coronavirus disease 2019(COVID-19).Methods·A total of 64 patients with positive nucleic acid test results for COVID-19 and accompanying cardiovascular symptoms who visited Shanghai Sixth People's Hospital,Shanghai Jiao Tong University School of Medicine,between January 2024 and June 2025 were enrolled.All patients underwent cardiac troponin I(cTnI)testing and CMR examination within 6 months after infection.According to cTnI levels,patients were divided into an elevated cTnI group[cTnI(+),n=26]and a non-elevated cTnI group[cTnI(-),n=38].In addition,37 age-and gender-matched individuals without prior COVID-19 infection were included as healthy controls.Baseline clinical characteristics and CMR parameters,including cardiac function and volumetric parameters,left ventricular global and segmental strain parameters,and myocardial tissue characterization parameters,were collected and compared among the three groups.Spearman rank correlation analysis was performed to evaluate the associations between cTnI and baseline clinical characteristics as well as CMR parameters.Univariate and multivariate Logistics regression analyses were used to establish a diagnostic model for early identification of COVID-19-related myocardial injury.Receiver operator characteristic(ROC)curve analysis and the DeLong test were used to assess the discriminative performance of the model.Results·Comparative analysis of cardiac function and volumetric parameters showed no significant differences in indices such as left ventricular ejection fraction(LVEF)among the three groups.Compared with the healthy control group,the cTnI(+)group showed decreased left ventricular global circumferential strain(GCS),left ventricular basal-level circumferential strain(CSBasal),and left ventricular mid-level circumferential strian(CSMid)(P<0.001),as well as increased Native T1 mapping values(P<0.001);the cTnI(-)group also showed elevated Native T1 mapping values(P=0.007).Correlation analysis showed that cTnI was significantly negatively correlated with CSMid(r=‒0.600,P<0.001).Multivariate Logistic regression analysis revealed that CSMid and Native T1 mapping were independent predictors of COVID-19-related myocardial injury(P<0.001).ROC curve analysis showed that the combined diagnostic model based on CSMid and Native T1 mapping demonstrated good discriminative performance(AUC=0.950).Conclusion·The CMR-based diagnostic model combining CSMid and Native T1 mapping can effectively identify potential myocardial injury in patients with mild COVID-19.It may provide objective imaging evidence for the early detection and clinical evaluation of COVID-19-related myocardial injury.关键词
新型冠状病毒感染/心肌损伤/心肌应变/Native T1 mapping/心脏磁共振Key words
coronavirus disease 2019(COVID-19)/myocardial injury/myocardial strain/Native T1 mapping/cardiac magnetic resonance(CMR)分类
医药卫生引用本文复制引用
旦增曲央,肖活源,张清晨,刘雨婷,康桑,冯锐,潘静薇..心脏磁共振对COVID-19轻症患者心肌损伤的诊断价值[J].上海交通大学学报（医学版）,2026,46(3):322-331,10.基金项目
上海市2023年度"探索者计划"项目(23TS1400700). Shanghai Explorer Program 2023(23TS1400700). （23TS1400700）
