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高血压性心脏病:MR 组织相位图揭示左心室旋转和局部心肌长轴速度改变。

Hypertensive heart disease: MR tissue phase mapping reveals altered left ventricular rotation and regional myocardial long-axis velocities.

机构信息

Heart Center Freiburg University, Cardiology and Angiology I, Albert-Ludwigs-University Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.

出版信息

Eur Radiol. 2013 Feb;23(2):339-47. doi: 10.1007/s00330-012-2613-0. Epub 2012 Aug 11.

Abstract

OBJECTIVES

The aim of this study was the evaluation of left ventricular (LV) segmental 3D velocities in patients with hypertensive heart disease using magnetic resonance (MR) tissue phase mapping (TPM).

METHODS

LV radial, long-axis and rotational myocardial velocities were assessed by TPM in patients with LV hypertrophy and preserved EF (n = 18, age = 53 ± 12 years) and volunteers (n = 20, age = 51 ± 4 years). Systolic and diastolic peak and time-to-peak velocities were mapped onto a 16-segment LV model. 3D myocardial motion was displayed on an extended visualisation model. Correlation coefficients were calculated to investigate differences in regional dynamics.

RESULTS

Patients revealed diastolic dysfunction as expressed by decreased peak long-axis velocities in all (except apical) segments (basal, P ≤ 0.01; two midventricular segments, P = 0.02, P = 0.03). During systole, hypertrophy was associated with heterogeneous behaviour for long-axis velocities including an increase in anteroseptal apical and midventricular regions (P = 0.001), a reduction in mid-inferior segments (P = 0.03) and enhanced septal velocities (P < 0.05). Segmental correlation analysis revealed altered dynamics of LV base rotation and increased dyssynchrony of lateral long-axis motion.

CONCLUSIONS

Patients with hypertensive heart disease demonstrated alterations in systolic long-axis motion, basal rotation and dyssynchrony. Longitudinal studies are needed to investigate the value of regional wall motion abnormalities regarding disease progression and outcome.

摘要

目的

本研究旨在利用磁共振组织相位图(TPM)评估高血压性心脏病患者左心室(LV)节段 3D 速度。

方法

通过 TPM 评估 LV 肥厚和保留 EF 的患者(n=18,年龄=53±12 岁)和志愿者(n=20,年龄=51±4 岁)的 LV 径向、长轴和旋转心肌速度。收缩期和舒张期峰值和达峰时间速度被映射到 16 节段的 LV 模型上。3D 心肌运动在扩展可视化模型上显示。计算相关系数以研究区域动力学的差异。

结果

患者表现出舒张功能障碍,所有(除心尖外)节段的长轴速度峰值降低(基底段,P≤0.01;两个中间段,P=0.02,P=0.03)。在收缩期,肥厚与长轴速度的异质性行为相关,包括前间隔心尖和中间段区域的增加(P=0.001)、中下部段的减少(P=0.03)和间隔速度的增强(P<0.05)。节段相关分析显示 LV 基底旋转动力学改变和外侧长轴运动的同步性增加。

结论

高血压性心脏病患者表现出收缩期长轴运动、基底旋转和不同步的改变。需要进行纵向研究,以研究局部壁运动异常对疾病进展和预后的价值。

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