Exploring the Correlation between Syndrome Differentiation of Traditional Chinese Medicine of Non-Ischemic Cardiomyopathy and Myocardial Fibrosis Based on Cardiac MRI

OBJECTIVE  To investigate the correlation between syndrome differentiation of traditional Chinese medicine (TCM) of non-ischemic cardiomyopathy (NICM) and parameters of the cardiac volume and function, along with myocardial fibrosis.METHODS  We selected 64 patients clinically diagnosed with NICM from September 2019 to October 2020 at Shunde Hospital of Southern Medical University. The patients were divided into three groups according to TCM syndrome differentiation, including the syndrome of stasis obstructing the heat blood, syndrome of turbid phlegm obstruction, as well as the syndrome of neither stasis obstructing the heat blood nor turbid phlegm obstruction (heart yang insufficiency, heart-kidney yin deficiency, deficiency of both qi and yin, and cold congealing heart vessel). All patients underwent cardiac magnetic resonance (CMR), which includes black-blood sequence, bright-blood sequence, and late gadolinium enhancement (LGE). The CMR bright-blood sequence images were post-processed to obtain parameters of cardiac volume and function, including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), left ventricular stroke volume index (LVSVI), left ventricular cardiac output index (LVCOI), and left ventricular mass index (LVMI). The LGE left ventricular images were divided into 17 segments according to the American Heart Association (AHA) recommendations and were classified into grades one to three according to the segmental distribution of abnormal ventricular wall enhancement. In addition, statistical analysis was performed on the above data.RESULTS  The differences were statistically significant (P < 0.05) when comparing the LVEF in the turbid phlegm obstruction group and neither stasis obstructing the heat blood nor turbid phlegm obstruction groups. The differences were statistically significant (P < 0.05, P < 0.01) when comparing the LVEDVI in the turbid phlegm obstruction group, the stasis obstructing the heat blood group, as well as neither stasis obstructing the heat blood nor turbid phlegm obstruction groups. The differences were statistically significant (P < 0.01) when comparing the LVESVI in the turbid phlegm obstruction group and neither stasis obstructing the heat blood nor turbid phlegm obstruction groups. The difference was statistically significant (P < 0.05) when comparing myocardial fibrosis degree in the stasis obstructing the heat blood group with the turbid phlegm obstruction group.CONCLUSION  The TCM syndrome differentiation of NICM has some correlation with parameters of the cardiac volume and function as well as myocardial fibrosis degree. Thus, this study provides new ideas for objective research and new methods for revealing the essence of Chinese medicine through the semi-quantitative and quantitative study of TCM syndrome differentiation combined with modern magnetic resonance technology.