Azarisman Shah M, Carbone Angelo, Shirazi Mitra, Bradley Julie, Teo Karen S, Worthley Matthew I, Worthley Stephen G
Department of Medicine, University of Adelaide, Adelaide, SA, Australia; Cardiovascular Research Centre, Royal Adelaide Hospital, Adelaide, SA, Australia; Department of Internal Medicine, International Islamic University Malaysia, Pahang, Malaysia.
Department of Medicine, University of Adelaide, Adelaide, SA, Australia; Cardiovascular Research Centre, Royal Adelaide Hospital, Adelaide, SA, Australia.
Heart Lung Circ. 2016 Nov;25(11):1094-1106. doi: 10.1016/j.hlc.2016.03.011. Epub 2016 Apr 30.
Cardiovascular magnetic resonance (CMR) advances in imaging techniques, permits the ability to accurately characterise tissue injury post myocardial infarction. Pre-contrast T1 mapping enables this through measurement of pre-contrast T1 relaxation times. We investigate the relationship between T1 characterisation of myocardial injury with global and regional diastolic function.
Revascularised acute myocardial infarction patients with normal left ventricular (LV) systolic function on TTE were assessed by 1.5T CMR. Acute regional diastolic wall motion abnormalities, global diastolic function measurements, acute segmental damage fraction with LGE and mean segmental pre-contrast T1 values were assessed on matching short axis slices.
Forty-four patients were analysed. Mean LVEF was 62.1±9.4%. No difference between NSTEMI (22/44) and STEMI in mean pre-contrast T1 values of infarcted (1025.0±109.2 vs 1011.0±81.6ms, p=0.70), adjacent (948.3±45.3 vs 941.1±46.6ms, p=0.70) and remote (888.8±52.8 vs 881.2±54.5ms, p=0.66) segments was detected. There was no correlation between pre-contrast T1 of infarcted segments with global diastolic dysfunction (E/A, r=0.216, p=0.06; S/D, r=0.243, p=0.053; E/E', r=0.240, p=0.072), but there was significantly positive, moderate correlation with circumferential diastolic strain rate, (r=0.579, p<0.01) with excellent agreement and reproducibility.
Cardiac magnetic resonance evaluation of pre-contrast T1 values revealed no difference between NSTEMI and STEMI patients in terms of tissue characterisation post-myocardial infarction. However, pre-contrast T1 of infarcted tissue is significantly correlated with regional diastolic circumferential strain rate.
心血管磁共振成像技术不断进步，能够准确地对心肌梗死后的组织损伤进行特征描述。对比增强前T1映射通过测量对比增强前T1弛豫时间来实现这一点。我们研究心肌损伤的T1特征与整体及局部舒张功能之间的关系。
对经胸超声心动图（TTE）检查显示左心室（LV）收缩功能正常的急性心肌梗死血运重建患者进行1.5T心血管磁共振成像（CMR）评估。在匹配的短轴切片上评估急性局部舒张期壁运动异常、整体舒张功能测量值、延迟强化（LGE）的急性节段损伤分数以及节段平均对比增强前T1值。
分析了44例患者。平均左心室射血分数（LVEF）为62.1±9.4%。非ST段抬高型心肌梗死（NSTEMI，22/44）和ST段抬高型心肌梗死（STEMI）患者梗死节段（1025.0±109.2对1011.0±81.6毫秒，p = 0.70）、相邻节段（948.3±45.3对941.1±46.6毫秒，p = 0.70）和远隔节段（888.8±52.8对881.2±54.5毫秒，p = 0.66）的平均对比增强前T1值无差异。梗死节段的对比增强前T1与整体舒张功能障碍（E/A，r = 0.2l6，p = 0.06；S/D，r = 0.243，p = 0.053；E/E'，r = 0.240，p = 0.072）之间无相关性，但与圆周方向舒张期应变率呈显著正相关且具有中等相关性（r = 0.579，p<0.01），一致性和可重复性良好。
对比增强前T1值的心脏磁共振评估显示，NSTEMI和STEMI患者在心肌梗死后的组织特征方面无差异。然而，梗死组织的对比增强前T1与局部舒张期圆周方向应变率显著相关。
