Chen Yin Yin, Yun Hong, Jin Hang, Kong De Hong, Long Yu Liang, Fu Cai Xia, Yang Shan, Zeng Meng Su
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Medical Imaging, Shanghai Medical school, Fudan University, Shanghai, China.
Int J Cardiovasc Imaging. 2017 Aug;33(8):1179-1189. doi: 10.1007/s10554-017-1095-1. Epub 2017 Mar 17.
In precapillary pulmonary hypertension (PH) patients, we sought to (1) investigate the relationship between ventricular insertion point (VIP) T1 times, hemodynamic parameters, and biventricular function, and (2) determine the predictors of anterior and inferior VIP T1 time. Twenty-two patients with precapillary PH underwent 1.5-T cardiac MR, right heart catheterization (RHC), and echocardiography. A group of 10 healthy age- and sex-matched volunteers served as controls. Biventricular function, morphology and mass were obtained from short-axis cine images. Native T1 times at anterior, inferior VIP, septum and LV lateral wall were respectively derived from all subjects. Mixed venous oxygen saturation (SvO) was the strongest hemodynamic parameters correlating with anterior (r = -0.67, P = 0.001) and inferior VIP T1 time (r = -0.81, P < 0.001). Elevated VIP T1 times were associated with reduced right ventricular (RV) ejection fraction, RV longitudinal and transverse motion, and increased RV end-diastolic and end-systolic volume index. LV diastolic function, quantified as mitral E velocity, was negatively correlated with anterior, inferior VIP (r = -0.55, P = 0.01) and septal T1 times (r = -0.50, P = 0.02), and positively correlated with RV systolic function and wall motion. In multivariate linear regression analyses, systolic eccentricity index (sEI) was the independent predictor of average VIPs T1 time (β= 0.47, P < 0.01), and remained significant correlation after adjustment of RHC and demographic parameters. In patients with precapillary PH, VIP T1 times are associated with biventricular function and hemodynamic parameters. Among all the parameters, sEI acts as a determinant of average VIPs T1 time.
在毛细血管前性肺动脉高压（PH）患者中，我们试图：（1）研究心室插入点（VIP）T1时间、血流动力学参数和双心室功能之间的关系，以及（2）确定前壁和下壁VIP T1时间的预测因素。22例毛细血管前性PH患者接受了1.5-T心脏磁共振成像、右心导管检查（RHC）和超声心动图检查。一组10名年龄和性别匹配的健康志愿者作为对照。从短轴电影图像中获取双心室功能、形态和质量。所有受试者均分别获取前壁、下壁VIP、室间隔和左心室侧壁的固有T1时间。混合静脉血氧饱和度（SvO）是与前壁（r = -0.67，P = 0.001）和下壁VIP T1时间（r = -0.81，P < 0.001）相关性最强的血流动力学参数。VIP T1时间升高与右心室（RV）射血分数降低、RV纵向和横向运动减少以及RV舒张末期和收缩末期容积指数增加有关。以二尖瓣E波速度量化的左心室舒张功能与前壁、下壁VIP（r = -0.55，P = 0.01）和室间隔T1时间（r = -0.50，P = 0.02）呈负相关，与RV收缩功能和室壁运动呈正相关。在多变量线性回归分析中，收缩期偏心指数（sEI）是平均VIPs T1时间的独立预测因素（β = 0.47，P < 0.01），在调整RHC和人口统计学参数后仍具有显著相关性。在毛细血管前性PH患者中，VIP T1时间与双心室功能和血流动力学参数相关。在所有参数中，sEI是平均VIPs T1时间的决定因素。
