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应用心脏磁共振斑点追踪技术对原发性高血压患者心肌形变的早期及定量评估。

Early and Quantitative Assessment of Myocardial Deformation in Essential Hypertension Patients by Using Cardiovascular Magnetic Resonance Feature Tracking.

机构信息

Department of Radiology, Zhengzhou University People's Hospital, Central China Fuwai Hospital, Heart Center of Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, People's Republic of China.

Department of Cardiac MR, Fuwai Hospital, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Beijing, 100037, People's Republic of China.

出版信息

Sci Rep. 2020 Feb 27;10(1):3582. doi: 10.1038/s41598-020-60537-x.

Abstract

The aims of the study were to identify subclinical global systolic function abnormalities and evaluate influencing factors associated with left ventricular (LV) strain parameters in hypertensive subjects using cardiovascular magnetic resonance imaging feature tracking (CMR-FT). The study enrolled 57 patients with essential hypertension (mean age: 43.04 ± 10.90 years; 35 males) and 26 healthy volunteers (mean age: 38.69 ± 10.44 years; 11 males) who underwent clinical evaluation and CMR examination. Compared with controls, hypertensive patients had significantly impaired myocardial strain values while ejection fraction (EF) did not differ. After multivariate regression analyses adjustment for confounders, the global radial strains (GRS) was independently associated with the mean arterial pressure (MAP) and left ventricular mass index (LVMI) (β = -0.219, p = 0.009 and β = -0.224, p = 0.015, respectively; Adjusted R = 0.4); the global circumferential strains (GCS) was also independently associated with the MAP and LVMI (β = 0.084, p = 0.002 and β = 0.073, p = 0.01, respectively; Adjusted R = 0.439); the global longitudinal strains (GLS) was independently associated with the Age and MAP (β = 0.065, p = 0.021 and β = 0.077, p = 0.009, respectively; Adjusted R = 0.289). Myocardial strain can early detect the myocardial damage and may be an appropriate target for preventive strategies before abnormalities of EF.

摘要

本研究旨在通过心脏磁共振(CMR)影像特征追踪(FT)技术识别亚临床整体收缩功能异常,并评估与左心室(LV)应变参数相关的影响因素。研究纳入 57 例原发性高血压患者(平均年龄:43.04±10.90 岁;35 名男性)和 26 名健康志愿者(平均年龄:38.69±10.44 岁;11 名男性),所有受试者均接受临床评估和 CMR 检查。与对照组相比,高血压患者的心肌应变值明显受损,而射血分数(EF)无差异。经多变量回归分析校正混杂因素后,整体径向应变(GRS)与平均动脉压(MAP)和左心室质量指数(LVMI)独立相关(β=-0.219,p=0.009 和 β=-0.224,p=0.015;调整后的 R²=0.4);整体周向应变(GCS)也与 MAP 和 LVMI 独立相关(β=0.084,p=0.002 和 β=0.073,p=0.01;调整后的 R²=0.439);整体纵向应变(GLS)与年龄和 MAP 独立相关(β=0.065,p=0.021 和 β=0.077,p=0.009;调整后的 R²=0.289)。心肌应变可早期发现心肌损伤,可能是 EF 异常前预防策略的合适靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/975c/7046638/61af147ba60c/41598_2020_60537_Fig1_HTML.jpg

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