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左心室心肌T1映射和应变分析评估甲状腺功能减退症中的心脏异常。

Left ventricular myocardial T1 mapping and strain analysis evaluate cardiac abnormality in hypothyroidism.

作者信息

Liu Min, Liu Weifang, Zhang Peiyao, An Jing, Wang Guang

机构信息

Department of Radiology, China-Japan Friendship Hospital, 2 Yinghua Dong Street, Hepingli, Chao Yang District, Beijing, 100029, China.

Collaborations NE Asia, Siemens Healthcare, Wang JingRoad No.9, Beijing, 100019, China.

出版信息

Int J Cardiovasc Imaging. 2019 Mar;35(3):507-515. doi: 10.1007/s10554-018-1456-4. Epub 2018 Sep 24.

Abstract

Cardiovascular Magnetic Resonance (CMR)-based T1 mapping and Heart Deformation Analysis (CMR-HDA) can assess the myocardial tissue characteristic and strain of cardiomyopathy. Whether they can assess cardiac abnormality of hypothyroidism (HT) is unknown. We aim to analysis left ventricular (LV) T1 values and strain of patients with overt HT (OHT) and subclinical HT (SHT) with CMR-based T1 mapping and HDA. This study prospectively included 32 OHT patients, 23 SHT patients and 27 healthy controls who underwent CMR. LV T1 mapping was obtained with a Modified Look-Locker Inversion Recovery sequence while LV circumferential strain (LVCS) and radial strain (LVRS), LV longitudinal strain (LVLS) were respectively analyzed on the short-axial and four-chamber cines with HDA. LV Eject Fraction among three groups were similar (p = 0.676). LV myocardial T1 correlated with LVCS (r = 0.734, p < 0.001) and LVRS (r = - 0.340, p = 0.011). LV myocardial T1 of OHT patients significantly increased in comparison with SHT patients (t = 5.403, p < 0.001) and normal controls (t = 10.197, p < 0.001), meanwhile, LV myocardial T1 of SHT patients were higher than that of controls (t = 2.629, p = 0.013). Compared with SHT patients (t = 1.925, p = 0.031) and normal controls (t = 2.875, p = 0.006), LVCS of OHT patients reduced while LVCS of SHT patients were lower than that of normal controls (t = 2.451, p = 0.020). LVRS of SHT patients were higher than OHT patients (t = 2.778, p = 0.008), but comparable to normal controls (t = 1.134, p = 0.266). LVLS of SHT and OHT significantly impaired in comparison with normal control. The increased LV myocardial T1 value and reduced strain were found in HT. CMR-based LV myocardial T1 and stain analysis are useful to evaluate myocardial tissue characteristic and mechanics in both overt and subclinical hypothyroidism.

摘要

基于心血管磁共振(CMR)的T1映射和心脏变形分析(CMR-HDA)可以评估心肌病的心肌组织特征和应变。它们是否能够评估甲状腺功能减退症(HT)的心脏异常尚不清楚。我们旨在通过基于CMR的T1映射和HDA分析显性HT(OHT)和亚临床HT(SHT)患者的左心室(LV)T1值和应变。本研究前瞻性纳入了32例OHT患者、23例SHT患者和27例接受CMR检查的健康对照者。使用改良的Look-Locker反转恢复序列获得LV T1映射,同时在短轴和四腔电影上分别用HDA分析LV圆周应变(LVCS)、径向应变(LVRS)和LV纵向应变(LVLS)。三组间的LV射血分数相似(p = 0.676)。LV心肌T1与LVCS(r = 0.734,p < 0.001)和LVRS(r = -0.340,p = 0.011)相关。与SHT患者(t = 5.403,p < 0.001)和正常对照者(t = 10.197,p < 0.001)相比,OHT患者的LV心肌T1显著升高,同时,SHT患者的LV心肌T1高于对照者(t = 2.629,p = 0.013)。与SHT患者(t = 1.925,p = 0.031)和正常对照者(t = 2.875,p = 0.006)相比,OHT患者的LVCS降低,而SHT患者的LVCS低于正常对照者(t = 2.451,p = 0.020)。SHT患者的LVRS高于OHT患者(t = 2.778,p = 0.008),但与正常对照者相当(t = 1.134,p = 0.266)。与正常对照相比,SHT和OHT患者的LVLS显著受损。在HT中发现LV心肌T1值升高和应变降低。基于CMR的LV心肌T1和应变分析有助于评估显性和亚临床甲状腺功能减退症的心肌组织特征和力学情况。

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