Centro de Investigación en Imagen Computacional y Tecnologías de Simulación en Biomedicina (CISTIB), Departamento de Tecnologías de la Información y las Comunicaciones, Universitat Pompeu Fabra, Barcelona, España.
Rev Esp Cardiol. 2010 Nov;63(11):1281-91. doi: 10.1016/s1885-5857(10)70253-x.
In hypertrophic cardiomyopathy (HCM), it has been suggested that regional fiber disarray produces segments that exhibit no or severely reduced deformation, and that these segments are distributed nonuniformly within the left ventricle (LV). This contrasts with observations in other types of hypertrophy, such as in athlete's heart or hypertensive left ventricular hypertrophy (HLVH), in which abnormal cardiac deformation may exist but the reduction is not so severe that some segments exhibit no deformation. Our aim was to use the strain distribution to study deformation in HCM.
We used tagged magnetic resonance imaging to reconstruct LV systolic deformation in 12 controls, 10 athletes, 12 patients with HCM, and 10 patients with HLVH. Deformation was quantified using a fast nonrigid registration algorithm and peak radial and circumferential systolic strain values were determined in 16 LV segments.
Patients with HCM had significantly lower average strain values than individuals in other groups. However, while the deformation observed in healthy subjects and HLVH patients clustered around the mean, in HCM patients, segments with normal contraction coexisted with segments exhibiting no or significantly reduced deformation, which resulted in a greater heterogeneity of strain values. Moreover, some nondeforming segments were observed even when fibrosis and hypertrophy were absent.
The strain distribution characterized specific patterns of myocardial deformation in patients with LVH due to different etiologies. Patients with HCM had significantly lower mean strain values and a greater heterogeneity in strain values than controls, athletes and HLVH patients. In addition, they had nondeforming regions.
在肥厚型心肌病（HCM）中，有人提出局部纤维排列紊乱会产生无变形或严重变形减少的节段，这些节段在左心室（LV）内不均匀分布。这与其他类型的肥大，如运动员心脏或高血压性左心室肥大（HLVH）的观察结果形成对比，在这些情况下可能存在异常的心脏变形，但减少程度不那么严重，以至于一些节段没有变形。我们的目的是使用应变分布来研究 HCM 中的变形。
我们使用标记磁共振成像来重建 12 名对照、10 名运动员、12 名 HCM 患者和 10 名 HLVH 患者的 LV 收缩期变形。使用快速非刚性注册算法对变形进行量化，并确定 16 个 LV 节段的峰值径向和圆周收缩应变值。
HCM 患者的平均应变值明显低于其他组的个体。然而，虽然健康受试者和 HLVH 患者的变形观察值围绕平均值聚集，但在 HCM 患者中，正常收缩的节段与无变形或明显变形减少的节段共存，导致应变值的异质性更大。此外，即使没有纤维化和肥大，也观察到一些无变形的节段。
由于不同的病因，应变分布特征化了 LVH 患者心肌变形的特定模式。与对照组、运动员和 HLVH 患者相比，HCM 患者的平均应变值明显较低，应变值的异质性也较大。此外，他们还有无变形区域。
