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肺动脉僵硬度与右心室质量和功能独立相关:一项心脏磁共振成像研究。

Pulmonary Artery Stiffness Is Independently Associated with Right Ventricular Mass and Function: A Cardiac MR Imaging Study.

作者信息

Dawes Timothy J W, Gandhi Ajay, de Marvao Antonio, Buzaco Rui, Tokarczuk Paweł, Quinlan Marina, Durighel Giuliana, Diamond Tamara, Monje Garcia Laura, de Cesare Alain, Cook Stuart A, O'Regan Declan P

机构信息

From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);

出版信息

Radiology. 2016 Aug;280(2):398-404. doi: 10.1148/radiol.2016151527. Epub 2016 Feb 24.

Abstract

Purpose To determine the relationship between pulmonary artery (PA) stiffness and both right ventricular (RV) mass and function with cardiac magnetic resonance (MR) imaging. Materials and Methods The study was approved by the local research ethics committee, and all participants gave written informed consent. Cardiac MR imaging was performed at 1.5 T in 156 healthy volunteers (63% women; age range, 19-61 years; mean age, 36.1 years). High-temporal-resolution phase-contrast imaging was performed in the main and right PAs. Pulmonary pulse wave velocity (PWV) was determined by the interval between arterial systolic upslopes. RV function was assessed with feature tracking to derive peak systolic strain and strain rate, as well as peak early-diastolic strain rate. RV volumes, ejection fraction (RVEF), and mass were measured from the cine images. The association of pulmonary PWV with RV function and mass was quantified with univariate linear regression. Interstudy repeatability was assessed with intraclass correlation. Results The repeatability coefficient for pulmonary PWV was 0.96. Increases in pulmonary PWV and RVEF were associated with increases in age (r = 0.32, P < .001 and r = 0.18, P = .025, respectively). After adjusting for age (P = .090), body surface area (P = .073), and sex (P = .005), pulmonary PWV demonstrated an independent positive association with RVEF (r = 0.34, P = .026). Significant associations were also seen with RV mass (r = 0.41, P = .004), RV radial strain (r = 0.38, P = .022), and strain rate (r = 0.35, P = .002), and independent negative associations were seen with radial (r = 0.27, P = .003), longitudinal (r = 0.40, P = .007), and circumferential (r = 0.31, P = .005) peak early-diastolic strain rate with the same covariates. Conclusion Pulmonary PWV is reliably assessed with cardiac MR imaging. In subjects with no known cardiovascular disease, increasing PA stiffness is associated with increasing age and is also moderately associated with both RV mass and function after controlling for age, body surface area, and sex. (©) RSNA, 2016 Online supplemental material is available for this article.

摘要

目的

利用心脏磁共振成像(MR)确定肺动脉(PA)僵硬度与右心室(RV)质量及功能之间的关系。材料与方法:本研究经当地研究伦理委员会批准,所有参与者均签署了书面知情同意书。对156名健康志愿者(63%为女性;年龄范围19 - 61岁;平均年龄36.1岁)进行1.5T心脏MR成像检查。在主肺动脉和右肺动脉进行高时间分辨率相位对比成像。通过动脉收缩期上升斜率之间的时间间隔确定肺脉搏波速度(PWV)。采用特征追踪评估RV功能,以得出峰值收缩期应变和应变率以及舒张早期峰值应变率。从电影图像测量RV容积、射血分数(RVEF)和质量。采用单变量线性回归定量分析肺PWV与RV功能及质量的关联。通过组内相关评估研究间重复性。结果:肺PWV的重复性系数为0.96。肺PWV升高和RVEF升高均与年龄增加相关(分别为r = 0.32,P <.001和r = 0.

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