Dabir Darius, Meyer David, Kuetting Daniel, Luetkens Julian, Homsi Rami, Pizarro Carmen, Nadal Jennifer, Thomas Daniel
Radiology, University of Bonn, Germany.
Medicine II, Cardiology, Pneumology, and Angiology, University of Bonn, Germany.
Rofo. 2018 Aug;190(8):712-721. doi: 10.1055/a-0598-5099. Epub 2018 Jul 25.
The aim of this study was to investigate the diagnostic value of cardiac magnetic resonance (CMR)-derived strain parameters in patients with sarcoidosis, and to compare results to standard CMR markers of sarcoidosis (edema/T2 ratio, early gadolinium enhancement, late gadolinium enhancement) for prediction of disease outcome.
61 patients with biopsy-proven sarcoidosis underwent CMR examination. According to CMR results, patients were divided into two different groups: patients with (CMR+; n = 23) and without (CMR-; n = 38) findings consistent with cardiac sarcoidosis. In addition, a group of healthy age-matched volunteers (controls; n = 22) served as controls. Left ventricular functional parameters as well as left ventricular longitudinal and circumferential strain were evaluated in all three groups.
Compared to controls, global longitudinal strain (GLS) was significantly impaired in patients with sarcoidosis, irrespective of cardiac involvement. No significant differences in GLS could be revealed between CMR+ and CMR- patients. Circumferential strain parameters were significantly impaired in CMR+ patients in comparison to CMR- patients and controls, while no significant differences could be revealed between CMR- patients and controls. GLS was significantly lower in patients with a negative outcome compared to controls. Compared to the rest of the CMR+ and CMR- patients, the GLS in patients with a negative outcome was further reduced but did not reach statistical significance.
GLS is the only strain parameter detecting left ventricular functional impairment in sarcoidosis patients with otherwise unsuspicious CMR and controls. GLS is further reduced in patients with a negative outcome. Thus, GLS may have the potential to serve as a marker for early cardiac involvement in sarcoidosis.
· GLS is significantly impaired in sarcoidosis patients with an otherwise inconspicuous CMR, compared to controls. · GLS is reduced in patients with a negative outcome. · GLS may serve as a marker for early cardiac involvement in sarcoidosis.
· Dabir D, Meyer D, Kuetting D et al. Diagnostic Value of Cardiac Magnetic Resonance Strain Analysis for Detection of Cardiac Sarcoidosis. Fortschr Röntgenstr 2018; 190: 712 - 721.
本研究旨在探讨心脏磁共振成像(CMR)衍生的应变参数在结节病患者中的诊断价值,并将结果与结节病的标准CMR标志物(水肿/T2比值、钆剂早期强化、钆剂延迟强化)进行比较,以预测疾病转归。
61例经活检证实的结节病患者接受了CMR检查。根据CMR结果,患者被分为两组:有符合心脏结节病表现的患者(CMR+;n = 23)和无相关表现的患者(CMR-;n = 38)。此外,一组年龄匹配的健康志愿者(对照组;n = 22)作为对照。对所有三组患者评估左心室功能参数以及左心室纵向和圆周应变。
与对照组相比,结节病患者的整体纵向应变(GLS)显著受损,无论是否存在心脏受累。CMR+组和CMR-组患者之间的GLS无显著差异。与CMR-组患者和对照组相比,CMR+组患者的圆周应变参数显著受损,而CMR-组患者和对照组之间无显著差异。与对照组相比,转归不良的患者GLS显著降低。与CMR+组和CMR-组的其他患者相比,转归不良的患者GLS进一步降低,但未达到统计学意义。
GLS是唯一能检测出CMR和对照组无异常的结节病患者左心室功能损害的应变参数。转归不良的患者GLS进一步降低。因此,GLS可能有潜力作为结节病早期心脏受累的标志物。
·与对照组相比,CMR无明显异常的结节病患者GLS显著受损。·转归不良的患者GLS降低。·GLS可能作为结节病早期心脏受累的标志物。
·Dabir D, Meyer D, Kuetting D等。心脏磁共振应变分析对心脏结节病检测的诊断价值。Fortschr Röntgenstr 2018;190:712 - 721。