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心脏磁共振特征追踪:一种评估心肌应变的新方法。与健康志愿者和左心室肥厚患者的超声心动图斑点追踪比较。

Cardiac magnetic resonance feature tracking: a novel method to assess myocardial strain. Comparison with echocardiographic speckle tracking in healthy volunteers and in patients with left ventricular hypertrophy.

作者信息

Orwat Stefan, Kempny Aleksander, Diller Gerhard-Paul, Bauerschmitz Pia, Bunck Alexander Ch, Maintz David, Radke Robert M, Baumgartner Helmut

机构信息

Department of Cardiology and Angiology, Adult Congenital and Valvular Heart Disease Centre, University Hospital of Muenster, Muenster, Germany.

出版信息

Kardiol Pol. 2014;72(4):363-71. doi: 10.5603/KP.a2013.0319. Epub 2013 Dec 2.

Abstract

BACKGROUND

Left ventricular longitudinal strain (LV-LS) and strain rate (SR) are sensitive markers of early systolic dysfunction.

AIM

To evaluate the feasibility of a novel, cardiac magnetic resonance (CMR) based method known as feature tracking (FT) for the assessment of strain and SR, and to compare the CMR based results to those obtained on standard transthoracic echocardiography (TTE) in healthy volunteers and in patients with left ventricular hypertrophy cardiomyopathy (HCM).

METHODS

Overall, 20 healthy volunteers (ten male, mean age 24 ± 3 years) and 20 consecutive patients with HCM (12 male, mean age 47 ± 19 years) were included. Longitudinal and circumferential strain and SR of the left ventricle were measured on CMR at 1.5 Tesla and TTE and interobserver variability was assessed.

RESULTS

FT measurements were feasible in all subjects. A good agreement between global LV-LS measured on CMR (controls: 20.8 ± 3.0; HCM: 17.6 ± 3.8) and TTE (controls: 19.4 ± 2.1; HCM: 16.6 ± 2.9) was found, while the agreement was worse for circumferential strain and all SR measurements. For the left and right ventricles, interobserver reproducibility was higher for strain measurements compared to SR. Coefficients of variation were lowest for LV-LS (13.2%) by CMR.

CONCLUSIONS

FT analysis is a novel CMR based method for the analysis of myocardial strain and SR that is simple and correlates well with the echocardiographic measurements. Since CMR is unaffected by inadequate acoustic windows, FT may represent an attractive alternative to echocardiography in assessing the increasingly important parameters of myocardial deformation.

摘要

背景

左心室纵向应变(LV-LS)和应变率(SR)是早期收缩功能障碍的敏感标志物。

目的

评估一种基于心脏磁共振(CMR)的名为特征追踪(FT)的新方法用于评估应变和SR的可行性,并将基于CMR的结果与健康志愿者和左心室肥厚型心肌病(HCM)患者经胸标准超声心动图(TTE)获得的结果进行比较。

方法

共纳入20名健康志愿者(10名男性,平均年龄24±3岁)和20例连续的HCM患者(12名男性,平均年龄47±19岁)。在1.5特斯拉的CMR和TTE上测量左心室的纵向和圆周应变及SR,并评估观察者间的变异性。

结果

FT测量在所有受试者中均可行。发现CMR测量的整体LV-LS(对照组:20.8±3.0;HCM组:17.6±3.8)与TTE测量的结果(对照组:19.4±2.1;HCM组:16.6±2.9)之间具有良好的一致性,而圆周应变和所有SR测量的一致性较差。对于左心室和右心室,应变测量的观察者间可重复性高于SR。CMR测量的LV-LS变异系数最低(13.2%)。

结论

FT分析是一种基于CMR的用于分析心肌应变和SR的新方法,简单且与超声心动图测量结果相关性良好。由于CMR不受声学窗口不佳的影响,FT可能是评估日益重要的心肌变形参数时超声心动图的一个有吸引力的替代方法。

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