[1]狄多多,朱 熠,李博伟,等.心脏磁共振特征追踪技术在肥厚型心肌病左室心肌应变中的应用研究[J].医学信息,2023,36(12):107-111.[doi:10.3969/j.issn.1006-1959.2023.12.020]
　DI Duo-duo,ZHU Yi,LI Bo-wei,et al.Quantitative Evaluation of Left Ventricular Myocardial Strain in Hypertrophic Cardiomyopathy by Cardiac Magnetic Resonance Feature Tracking Technique[J].Journal of Medical Information,2023,36(12):107-111.[doi:10.3969/j.issn.1006-1959.2023.12.020]
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心脏磁共振特征追踪技术在肥厚型心肌病左室心肌应变中的应用研究()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年12期
页码:
107-111
栏目:
论著
出版日期:
2023-06-15

文章信息/Info

Title:
Quantitative Evaluation of Left Ventricular Myocardial Strain in Hypertrophic Cardiomyopathy by Cardiac Magnetic Resonance Feature Tracking Technique
文章编号:
1006-1959（2023）12-0107-05
作者:
狄多多; 朱 熠; 李博伟; 等
（1.安徽医科大学北京大学深圳医院临床学院，广东 深圳 518036；2.安徽医科大学第五临床医学院，安徽 合肥 230000；3.北京大学深圳医院医学影像科，广东 深圳 518036）
Author(s):
DI Duo-duo; ZHU Yi; LI Bo-wei; et al.
(1.Clinical College of Shenzhen Hospital,Peking University,Anhui Medical University,Shenzhen 518036,Guangdong,China;2.The Fifth Clinical Medical College of Anhui Medical University,Hefei 230000,Anhui,China;3.Department of Medical Imaging,Shenzhen Hospital,Peking University,Shenzhen 518036,Guangdong,China)
关键词:
特征追踪; 应变; 心肌病; 心功能; 心肌纤维化
Keywords:
Feature tracking; Strain; Hypertrophic cardiomyopathy; Cardiacfunction; Myocardial fibrosis
分类号:
R445.2；R542.2
DOI:
10.3969/j.issn.1006-1959.2023.12.020
文献标志码:
A
摘要:
目的 采用心脏磁共振特征追踪技术（CMR-FT）对肥厚型心肌病患者（HCM）心肌力学进行分析，探讨其在HCM患者中的诊断价值。方法 回顾性收集于北京大学深圳医院2017年1月1日-2022年12月31日行心脏磁共振检查的HCM患者35例，同时纳入41名同期健康志愿者作为对照组。HCM患者根据射血功能是否正常分为射血功能正常组（LVEF≥50%）24例和射血功能降低组（LVEF＜50%）11例。另外HCM患者根据是否出现延迟强化，分为延迟强化阴性组（LGE-）20例和延迟强化阳性组（LGE+）15例。采用心脏磁共振特征追踪技术对所有受试者进行左心室心肌应变分析，获得心肌的径向应变、周向应变及纵向应变。结果 LVEF＜50%亚组、LVEF≥50%亚组与对照组比较，左心室的总体心肌应变峰值逐渐升高，差异有统计学意义（P＜0.05）；HCM患者LGE+组、LGE-组与对照组比较，左心室总体应变峰值逐渐升高，差异有统计学意义（P＜0.05）；心肌整体应变峰值对HCM具有较好的诊断效能，GRS、GCS、GLS曲线下面积分别为0.810、0.916、0.943。结论 CMR-FT技术可以定量评估HCM患者左室心肌应变，早期反映心肌受损情况。左心室整体心肌应变峰值对HCM患者具有较好的诊断效能。
Abstract:
Objective To analyze the myocardial mechanics of patients with hypertrophic cardiomyopathy (HCM) by cardiac magnetic resonance feature tracking (CMR-FT), and to explore its diagnostic value in HCM patients.Methods A total of 35 patients with HCM who underwent cardiac magnetic resonance examination in Shenzhen Hospital of Peking University from January 1, 2017 to December 31, 2022 were retrospectively collected, and 41 healthy volunteers were included as the control group. According to the normal ejection function, HCM patients were divided into normal ejection function group (24 patients) (LVEF≥50%) and reduced ejection function group (11 patients) (LVEF＜50%). In addition, HCM patients were divided into delayed reinforcement negative group (LGE-) 20 cases and delayed reinforcement positive group (LGE+) 15 cases according to whether there was delayed reinforcement. The left ventricular myocardial strain analysis of all subjects was performed by using the cardiac magnetic resonance feature tracking technique, and the radial strain, circumferential strain and longitudinal strain of the myocardium were obtained.Results Compared with the control group, the total myocardial strain peak of left ventricle in LVEF＜50% and LVEF≥50% subgroups was gradually increased, and the difference was statistically significant (P<0.05). Compared with the control group, the peak value of left ventricular global strain in LGE+ group and LGE- group of HCM patients increased gradually, and the difference was statistically significant (P<0.05). The myocardial global strain peak had good diagnostic efficacy for HCM, and the areas under the curve of GRS, GCS and GLS were 0.810, 0.916 and 0.943, respectively.Conclusion CMR-FT technique can quantitatively evaluate the left ventricular myocardial strain in patients with HCM, and reflect the myocardial damage in early stage. The left ventricular global myocardial strain peak has better diagnostic efficacy in patients with HCM.

参考文献/References:

[1]Ommen SR,Mital S,Burke MA,et al.2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J].Circulation,2020,142(25):e533-e557.[2]Yang L,Zhang L,Cao S,et al.Advanced myocardial characterization in hypertrophic cardiomyopathy: feasibility of CMR-based feature tracking strain analysis in a case-control study[J].Eur Radiol,2020,30(11):6118-6128.[3]Sen-Chowdhry S,Jacoby D,Moon JC,et al.Update on hypertrophic cardiomyopathy and a guide to the guidelines[J].Nat Rev Cardiol,2016,13(11):651-675.[4]Camici PG,Olivotto I,Rimoldi OE.The coronary circulation and blood flow in left ventricular hypertrophy[J].J Mol Cell Cardiol,2012,52(4):857-864.[5]Sims JR,Anavekar NS,Bhatia S,et al.Clinical, Radiographic, and Microbiologic Features of Infective Endocarditis in Patients With Hypertrophic Cardiomyopathy[J].The American Journal of Cardiology,2018,121(4):480-484.[6]Claus P,Omar AMS,Pedrizzetti G,et al.Tissue Tracking Technology for Assessing Cardiac Mechanics: Principles, Normal Values, and Clinical Applications [J].JACC Cardiovasc Imaging,2015,8(12):1444-1460.[7]Von Knobelsdorff-Brenkenhoff F,Schulz-Menger J.Role of cardiovascular magnetic resonance in the guidelines of the European Society of Cardiology[J].J Cardiovasc Magn Reson,2016,18:6.[8]Kihlberg J,Gupta V,Haraldsson H,et al.Clinical validation of three cardiovascular magnetic resonance techniques to measure strain and torsion in patients with suspected coronary artery disease [J].J Cardiovasc Magn Reson,2020,22(1):83.[9]Nicholls M.The 2014 ESC Guidelines on the Diagnosis and Management of Hypertrophic Cardiomyopathy have been published[J].Eur Heart J,2014,35(41):2849-2850.[10]Cerqueira MD,Weissman NJ,Dilsizian V,et al.Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association [J].Circulation,2002,105(4):539-542.[11]Mazurkiewicz ?覵,Petryka J,Spiewak M,et al.Biventricular mechanics in prediction of severe myocardial fibrosis in patients with dilated cardiomyopathy: CMR study [J].Eur J Radiol,2017,91:71-81.[12]Kim MY,Park EA,Lee W,et al.Cardiac Magnetic Resonance Feature Tracking in Aortic Stenosis: Exploration of Strain Parameters and Prognostic Value in Asymptomatic Patients with Preserved Ejection Fraction[J].Korean J Radiol,2020,21(3):268-279.[13]Porcari A,Merlo M,Crosera L,et al.Strain analysis reveals subtle systolic dysfunction in confirmed and suspected myocarditis with normal LVEF. A cardiac magnetic resonance study [J].Clin Res Cardiol,2020,109(7):869-880.[14]Schuster A,Stahnke VC,Unterberg-Buchwald C,et al.Cardiovascular magnetic resonance feature-tracking assessment of myocardial mechanics: Intervendor agreement and considerations regarding reproducibility [J].Clin Radiol,2015,70(9):989-998.[15]Liu H,Yang D,Wan K,et al.Distribution pattern of left-ventricular myocardial strain analyzed by a cine MRI based deformation registration algorithm in healthy Chinese volunteers [J].Sci Rep,2017,7:45314.[16]Mangion K,Burke NMM,Mccomb C,et al.Feature-tracking myocardial strain in healthy adults- a magnetic resonance study at 3.0 tesla [J].Sci Rep,2019,9(1):3239.[17]Andre F,Steen H,Matheis P,et al.Age- and gender-related normal left ventricular deformation assessed by cardiovascular magnetic resonance feature tracking [J].J Cardiovasc MagnReson,2015,17(1):25.[18]刘红,杨丹,罗勇,等.特征追踪心脏磁共振技术测量汉族健康人群左心室心肌应变正常参考值的研究[J].四川大学学报(医学版),2016,47(4):599-604.[19]Cavus E,Muellerleile K,Schellert S,et al.CMR feature tracking strain patterns and their association with circulating cardiac biomarkers in patients with hypertrophic cardiomyopathy [J].Clin Res Cardiol,2021,110(11):1757-1769.[20]Mavrogeni S,Katsi V,Vartela V,et al.The emerging role of Cardiovascular Magnetic Resonance in the evaluation of hypertensive heart disease [J].BMC Cardiovasc Disord,2017,17(1):132.

更新日期/Last Update: 1900-01-01