Yang Li Tan, Yamashita Eiji, Nagata Yasufumi, Kado Yuichiro, Oshima Shigeru, Otsuji Yutaka, Takeuchi Masaaki
Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan.
Second Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
J Magn Reson Imaging. 2017 Apr;45(4):1034-1045. doi: 10.1002/jmri.25433. Epub 2016 Aug 17.
To study and compare the prognostic value of cardiac magnetic resonance feature tracking (MR-FT) of biventricular strain parameters with a conventional method.
We retrospectively enrolled 364 patients undergoing clinically indicated cardiac MR examinations (1.5 or 3T scanner). Standard steady-state free precession (SSFP) images were used for analysis. Left ventricular (LV) and right ventricular (RV) ejection fraction (EF) were measured using conventional disk-area summation methods. Biventricular strain parameters were measured using MR-FT. All patients were followed to record major adverse cardiac events (MACEs).
The correlations between LV volumes and LVEF using both methods were excellent (r = 0.87-0.98). RV strain parameters were modestly correlated with RVEF (r = 0.44-0.63). During a median follow-up of 15 months, 36 patients developed MACEs. All MR-FT-derived parameters except for RV global longitudinal strain were significantly associated with future MACEs (P < 0.05) in univariate analysis. In stepwise Cox proportional hazard models, RV global radial strain (RVGRS) provided incremental prognostic value in models adjusted for age, gender, conventional LVEF (hazard ratio 0.93; P = 0.029) or RVEF (hazard ratio 0.93; P = 0.038). LV global transverse strain (LVGTS) also offered additional value over age, gender, conventional LVEF (hazard ratio 0.94; P = 0.041), or RVEF (hazard ratio 0.94; P = 0.004). Kaplan-Meier analysis showed significant survival differences in subgroups stratified by the median value of LVGTS, RVGRS, and LVEF using MR-FT (all log-rank P < 0.05).
Deformation analysis of both ventricles using MR-FT provided significant prognostic power similar to parameters obtained using conventional methods. MR-FT is a promising alternative both for ventricular chamber quantification and for providing information of future cardiac events.
3 J. Magn. Reson. Imaging 2017;45:1034-1045.
研究并比较双心室应变参数的心脏磁共振特征追踪（MR-FT）与传统方法的预后价值。
我们回顾性纳入了364例接受临床指征心脏磁共振检查（1.5或3T扫描仪）的患者。使用标准稳态自由进动（SSFP）图像进行分析。采用传统的圆盘面积求和法测量左心室（LV）和右心室（RV）射血分数（EF）。使用MR-FT测量双心室应变参数。对所有患者进行随访以记录主要不良心脏事件（MACE）。
两种方法测得的LV容积与LVEF之间的相关性都很好（r = 0.87 - 0.98）。RV应变参数与RVEF的相关性中等（r = 0.44 - 0.63）。在中位随访15个月期间，36例患者发生了MACE。在单因素分析中，除RV整体纵向应变外，所有MR-FT衍生参数均与未来MACE显著相关（P < 0.05）。在逐步Cox比例风险模型中，RV整体径向应变（RVGRS）在调整了年龄、性别、传统LVEF（风险比0.93；P = 0.029）或RVEF（风险比0.93；P = 0.038）的模型中提供了增量预后价值。LV整体横向应变（LVGTS）在调整了年龄、性别、传统LVEF（风险比0.94；P = 0.041）或RVEF（风险比0.94；P = 0.004）的模型中也提供了额外价值。Kaplan-Meier分析显示，使用MR-FT按LVGTS、RVGRS和LVEF的中值分层的亚组中存在显著的生存差异（所有对数秩P < 0.05）。
使用MR-FT对双心室进行变形分析提供了与传统方法获得的参数相似的显著预后能力。MR-FT对于心室腔量化和提供未来心脏事件的信息都是一种有前景的替代方法。
3 J. Magn. Reson. Imaging 2017;45:1034 - 1045。
Zotero 插件