Leng Shuang, Jiang Meng, Zhao Xiao-Dan, Allen John Carson, Kassab Ghassan S, Ouyang Rong-Zhen, Tan Ju-Le, He Ben, Tan Ru-San, Zhong Liang
National Heart Centre Singapore, 5 Hospital Drive, Singapore, 169609, Singapore.
Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200001, People's Republic of China.
Ann Biomed Eng. 2016 Dec;44(12):3522-3538. doi: 10.1007/s10439-016-1695-2. Epub 2016 Jul 19.
Right ventricular (RV) dysfunction is known to be highly correlated with mortality and morbidity; nevertheless, imaging-based assessment of RV anatomy and physiology lags far behind that of the left ventricle. In this study, we advance RV imaging using cardiac magnetic resonance (CMR) to accomplish the following aims: (i) track the motion of six tricuspid annular (TA) sites using a semi-automatic tracking system; (ii) extract clinically important TA measurements-systolic velocity (Sm), early diastolic velocity (Em), late diastolic velocity (Am), and TA plane systolic excursion (TAPSE)-for each TA site and compare these CMR-derived measurements in healthy subjects vs. patients with heart failure, repaired tetralogy of Fallot, pulmonary hypertension, and hypertrophic cardiomyopathy; (iii) investigate how the TA motion related measurements compare with information provided by invasive right heart catheterization (RHC); (iv) evaluate the rate of change in surface area swept out by the reconstructed tricuspid annulus over time and (v) assess the reproducibility of this CMR-based technique. Results indicate that TA motion parameter data obtained in three dimensions using the proposed CMR-based systematic methodology achieve superior diagnostic performance (Sm: AUC = 0.957; TAPSE: AUC = 0.981) compared to two-dimensional CMR imaging. Both Sm and TAPSE from CMR correlated positively with dP/dt /IP from RHC (Sm: r = 0.621, p < 0.01; TAPSE: r = 0.648, p < 0.01). Our highly reproducible and robust methodology holds potential for extending CMR imaging to characterization of TA morphology and dynamic behaviour, eventually leading to deeper understanding of RV function and improved diagnostic capability.
右心室（RV）功能障碍与死亡率和发病率高度相关；然而，基于影像学对右心室解剖结构和生理功能的评估远远落后于左心室。在本研究中，我们利用心脏磁共振成像（CMR）推进右心室成像，以实现以下目标：（i）使用半自动跟踪系统追踪三尖瓣环（TA）六个位点的运动；（ii）提取每个TA位点临床上重要的TA测量值——收缩期速度（Sm）、舒张早期速度（Em）、舒张晚期速度（Am）和TA平面收缩期偏移（TAPSE），并比较健康受试者与心力衰竭、法洛四联症修补术后、肺动脉高压和肥厚型心肌病患者的这些CMR衍生测量值；（iii）研究TA运动相关测量值与有创右心导管检查（RHC）提供的信息相比如何；（iv）评估重建的三尖瓣环随时间扫过的表面积变化率；（v）评估这种基于CMR的技术的可重复性。结果表明，与二维CMR成像相比，使用所提出的基于CMR的系统方法在三维中获得的TA运动参数数据具有更高的诊断性能（Sm：AUC = 0.957；TAPSE：AUC = 0.981）。CMR的Sm和TAPSE均与RHC的dP/dt /IP呈正相关（Sm：r = 0.621，p < 0.01；TAPSE：r = 0.648，p < 0.01）。我们高度可重复且稳健的方法有潜力将CMR成像扩展到TA形态和动态行为的表征，最终有助于更深入地了解右心室功能并提高诊断能力。
