Clinical and Experimental Department of Medicine and Pharmacology, University of Messina, Messina, Italy.
Circ J. 2010 Jun;74(6):1205-13. doi: 10.1253/circj.cj-10-0017. Epub 2010 Apr 27.
The aim of our study was to assess longitudinal (L), circumferential (C) and radial (R) strain (S) of the left ventricle (LV) in patients with acute myocarditis and preserved LV wall motion.
Of the 26 male patients that were enrolled, 13 patients (26+/-8 years) suffered from acute myocarditis and 13 (25+/-2 years) were healthy participants (controls). Both patients and controls underwent cardiac magnetic resonance (CMR) and 2-dimensional S imaging (2D-S) echocardiography on the same day. Myocardial strains (RS, LS and CS) were quantified by 2D-S. In patients with myocarditis, a delayed enhancement (DE) CMR study was performed to identify damaged myocardial segments. In the myocarditis group there was a significant LS reduction compared with controls (-25+/-7 vs -20+/-7, P<0.0001), whereas no difference was found between the 2 groups concerning CS and RS. Subepicardial DE areas were found in 12 of 13 patients. Segments with DE showed a significantly lower LS in comparison with segments without DE (-19+/-4 vs -23+/-6, P<0.0001). In contrast, no difference in CS and RS was found when comparing segments with DE vs segments without DE.
In patients with acute myocarditis, evidence of subepicardial damage and no wall motion abnormalities, longitudinal deformation is diffusely impaired, whereas circumferential impairment is regionally sited in the areas of subepicardial damage.
本研究旨在评估急性期心肌炎伴左心室壁运动正常患者的左心室（LV）纵向（L）、周向（C）和径向（R）应变（S）的纵向变化。
在 26 名男性患者中，13 名（26±8 岁）患有急性心肌炎，13 名（25±2 岁）为健康参与者（对照组）。所有患者和对照组均在同一天接受心脏磁共振（CMR）和二维 S 成像（2D-S）超声心动图检查。通过 2D-S 量化心肌应变（RS、LS 和 CS）。在心肌炎患者中，进行延迟增强（DE）CMR 研究以识别受损的心肌节段。与对照组相比，心肌炎组的 LS 明显降低（-25±7 比-20±7，P<0.0001），而 CS 和 RS 两组之间无差异。在 13 例患者中有 12 例发现心外膜下 DE 区。与无 DE 节段相比，有 DE 节段的 LS 明显降低（-19±4 比-23±6，P<0.0001）。然而，在比较有 DE 和无 DE 的节段时，CS 和 RS 无差异。
在急性心肌炎患者中，尽管存在无壁运动异常的心外膜下损伤，但纵向变形普遍受损，而周向损伤局限于心外膜下损伤区域。
