Mazurkiewicz Ł, Orłowska-Baranowska E, Petryka J, Śpiewak M, Gawor M, Miłosz-Wieczorek B, Werys K, Małek Ł A, Marczak M, Grzybowski J
Department of Cardiomyopathies, CMR Unit, Institute of Cardiology, Warsaw, Poland.
Department of Acquired Cardiac Defects, Institute of Cardiology, Warsaw, Poland.
Clin Radiol. 2017 Apr;72(4):286-292. doi: 10.1016/j.crad.2016.10.024. Epub 2017 Jan 6.
To investigate changes in myocardial tissue volume during the cardiac cycle to verify the hypothesis of non-compressibility of the myocardium in healthy individuals (HI) as well as in patients with hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), and aortic stenosis (AS).
The study group included 30 HI, and patients with HCM (n=110), DCM (n=89), and AS (n=78). Left ventricular (LV) function, end-diastolic, and end-systolic volumes were calculated based on cardiac magnetic resonance imaging (CMR) for all participants.
End-systolic myocardial volumes were higher than end-diastolic in both controls (91.2±26.6 versus 85.1±24.3 ml, p<0.001) and in all patient groups: HCM (214.3±81.6 versus 176±64.2 ml, p<0.01), DCM (128.4±43.1 versus 115.4±42.9 ml, p<0.001) and AS (155.1±37.1 versus 129.4±34.6 ml, p<0.001). HCM and AS patients had significantly higher systolic volume gain than HI (21.5±8.3 versus 10.6±6.3%, p<0.01 and 18.3±5.7 versus 10.6±6.3% p=0.013, respectively). Conversely, DCM patients had lesser increases in myocardial systolic volume than HCM patients (11.2±4.8% versus 21.5±8.3, p=0.01) and AS patients (11.2±4.8% versus 18.3±5.7, p=0.02). No differences were found in systolic volume gain between AS and HCM patients (p=ns) or between DCM patients and HI (p=ns).
End-systolic myocardial volume was significantly higher than end-diastolic volume in all subsets of patients. The systolic volume gain was greater in individuals with hypertrophy than in those without.
研究心动周期中心肌组织体积的变化，以验证健康个体（HI）以及肥厚型心肌病（HCM）、扩张型心肌病（DCM）和主动脉瓣狭窄（AS）患者心肌不可压缩性的假设。
研究组包括30名HI以及HCM患者（n = 110）、DCM患者（n = 89）和AS患者（n = 78）。基于心脏磁共振成像（CMR）计算所有参与者的左心室（LV）功能、舒张末期和收缩末期容积。
对照组（91.2±26.6对85.1±24.3 ml，p<0.001）以及所有患者组（HCM：214.3±81.6对176±64.2 ml，p<0.01；DCM：128.4±43.1对115.4±42.9 ml，p<0.001；AS：155.1±37.1对129.4±34.6 ml，p<0.001）的收缩末期心肌容积均高于舒张末期。HCM和AS患者的收缩期容积增加显著高于HI（分别为21.5±8.3对10.6±6.3%，p<0.01；18.3±5.7对10.6±6.3%，p = 0.013）。相反，DCM患者心肌收缩期容积的增加低于HCM患者（11.2±4.8%对21.5±8.3，p = 0.01）和AS患者（11.2±4.8%对18.3±5.7，p = 0.02）。AS和HCM患者之间（p = 无显著差异）或DCM患者和HI之间（p = 无显著差异）的收缩期容积增加无差异。
所有患者亚组的收缩末期心肌容积均显著高于舒张末期容积。肥厚个体的收缩期容积增加大于非肥厚个体。
