Lin Lian-Yu, Su Mao-Yuan M, Pham Van-Truong, Tran Thi-Thao, Wang Yung-Hung, Tseng Wen-Yih I, Lo Men-Tzung, Lin Jiunn-Lee
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan.
Sci Rep. 2016 Feb 15;6:20868. doi: 10.1038/srep20868.
Left ventricular (LV) trabeculation has been studied in certain forms of cardiomyopathy. However, the changes of LV endocardial trabeculation during the remodeling process leading to heart failure (HF) are unclear. Seventy-four patients with systolic heart failure (SHF), 65 with heart failure with preserved ejection fraction (HFpEF) and 61 without HF were prospectively enrolled. All subjects received magnetic resonance imaging (MRI) study including cine, T1 and late gadolinium enhancement (LGE) images. Trabecular-papillary muscle (TPM) mass, fractal dimension (FD) and extracellular volume (ECV) were derived. The results showed that TPM mass index was higher in patients with SHF than that in patients with HFpEF and non-HF. The TPM mass-LV mass ratio (TPMm/LVM) was higher in SHF group than that in HFpEF and non-HF. FD was not different among groups. The presence of LGE was inversely associated with TPM mass index and TPMm/LVM while the ECV were positively associated with TPMm/LVM. The FD was positively associated with LV chamber size. In conclusion, TPM increases in patients with SHF and are probably related to myocardial cell hypertrophy and fibrotic repair during remodeling. The FD increases with the dilatation of LV chamber but remain unchanged with the deterioration of LV function.
左心室（LV）小梁形成已在某些形式的心肌病中得到研究。然而，导致心力衰竭（HF）的重塑过程中左心室内膜小梁的变化尚不清楚。前瞻性纳入了74例收缩性心力衰竭（SHF）患者、65例射血分数保留的心力衰竭（HFpEF）患者和61例无HF患者。所有受试者均接受了磁共振成像（MRI）检查，包括电影成像、T1加权成像和延迟钆增强（LGE）成像。得出小梁-乳头肌（TPM）质量、分形维数（FD）和细胞外容积（ECV）。结果显示，SHF患者的TPM质量指数高于HFpEF患者和无HF患者。SHF组的TPM质量与左心室质量比（TPMm/LVM）高于HFpEF组和无HF组。各组间FD无差异。LGE的存在与TPM质量指数和TPMm/LVM呈负相关，而ECV与TPMm/LVM呈正相关。FD与左心室腔大小呈正相关。总之，SHF患者的TPM增加，可能与重塑过程中的心肌细胞肥大和纤维化修复有关。FD随左心室腔扩张而增加，但随左心室功能恶化而保持不变。
