Department of Cardiovascular Imaging, Clínica La Sagrada Familia-ENERI, Buenos Aires, Argentina.
Int J Cardiovasc Imaging. 2012 Apr;28(4):795-801. doi: 10.1007/s10554-011-9883-5. Epub 2011 May 7.
To explore left ventricular filling patterns in patients with a history of previous myocardial infarction (MI) using time-volume curves obtained from conventional cine-cardiac magnetic resonance (CMR) examinations. Consecutive patients with a history of previous MI who were referred for CMR evaluation constituted the study population, and a consecutive cohort of sex and age-matched patients with a normal CMR constituted the control group. The following CMR diastolic parameters were evaluated: peak filling rate (PFR), time to PFR (tPFR), normalised PFR adjusted for diastolic volume at PFR (nPFR), and percent RR interval between end systole and PFR. Fifty patients were included, 25 with a history of previous MI and 25 control. The mean age was 59.6 ± 13.9 years and 27 (54%) were male. Within the control group, age was significantly related to PFR (r = -0.53, p = 0.007), whereas among patients with previous MI age was not related to PFR (r = -0.16, p = 0.44). PFR (252.4 ± 96.7 ml/s vs. 316.0 ± 126.4 ml/s, p = 0.05) and nPFR (1.6 ± 1.2 vs. 3.3 ± 1.5, p < 0.001) were significantly lower in patients with previous MI, whereas no significant differences were detected regarding tPFR (143.0 ± 67.5 ms vs. 176.2 ± 83.9 ms, p = 0.13) and % RR to PFR (18.1 ± 9.7% vs. 20.6 ± 12.2%, p = 0.44). MI size was related to LV ejection fraction (r = -0.76, p < 0.001), PFR (r = -0.40, p = 0.004), nPFR (r = -0.52, p < 0.001) and left atrium area (r = 0.40, p = 0.004). Patients at the lowest PFR quartile (<200 ml/s) showed a larger MI size (Q1 26.5 ± 25.5%, Q2 15.5 ± 20.9%, Q3 6.3 ± 12.4%, Q4 8.8 ± 14.1%, p = 0.04). At multivariate analysis, MI size was the only independent predictor of the lowest PFR (p = 0.017). Infarct size has an impact on LV filling profiles, as assessed by conventional cine CMR without additional specific pulse sequences.
探讨既往心肌梗死（MI）病史患者的左心室充盈模式，使用常规电影心脏磁共振（CMR）检查获得的时间-容积曲线。既往 MI 病史并接受 CMR 评估的连续患者构成研究人群，而连续性别和年龄匹配的正常 CMR 患者构成对照组。评估以下 CMR 舒张参数：峰值充盈率（PFR）、达到 PFR 的时间（tPFR）、用 PFR 时的舒张容积校正的标准化 PFR（nPFR）和从收缩末期到 PFR 的 RR 间隔百分比。纳入 50 例患者，其中 25 例有既往 MI 病史，25 例为对照组。平均年龄为 59.6±13.9 岁，27 例（54%）为男性。在对照组中，年龄与 PFR 显著相关（r=-0.53，p=0.007），而在既往 MI 患者中，年龄与 PFR 无相关性（r=-0.16，p=0.44）。既往 MI 患者的 PFR（252.4±96.7 ml/s 与 316.0±126.4 ml/s，p=0.05）和 nPFR（1.6±1.2 与 3.3±1.5，p<0.001）明显降低，而 tPFR（143.0±67.5 ms 与 176.2±83.9 ms，p=0.13）和 RR 间期至 PFR 的百分比（18.1±9.7%与 20.6±12.2%，p=0.44）无显著差异。MI 大小与 LV 射血分数（r=-0.76，p<0.001）、PFR（r=-0.40，p=0.004）、nPFR（r=-0.52，p<0.001）和左心房面积（r=0.40，p=0.004）相关。处于最低 PFR 四分位数（<200 ml/s）的患者显示出更大的 MI 大小（Q1 26.5±25.5%、Q2 15.5±20.9%、Q3 6.3±12.4%、Q4 8.8±14.1%，p=0.04）。多变量分析显示，MI 大小是最低 PFR 的唯一独立预测因素（p=0.017）。梗死大小对 LV 充盈模式有影响，通过常规电影 CMR 评估，无需额外的特定脉冲序列。
