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预测肥厚型心肌病患者左心室流出道梗阻的心肌力学参数:心血管磁共振特征追踪分析。

Myocardial Mechanics Parameters That Predict Left Ventricular Outflow Tract Obstruction in Patients With Hypertrophic Cardiomyopathy: A Cardiovascular Magnetic Resonance Feature Tracking Analysis.

机构信息

Department of Radiology.

Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease.

出版信息

J Comput Assist Tomogr. 2021;45(1):65-72. doi: 10.1097/RCT.0000000000000977.

Abstract

OBJECTIVE

To identify left ventricular (LV) myocardial mechanics predictors of LV outflow tract obstruction (LVOTO) in patients with hypertrophic cardiomyopathy (HCM).

METHODS

Thirty-nine adults with HCM and 21 controls underwent cardiovascular magnetic resonance. The feature tracking (FT) analysis results of HCM patients with and without LVOTO and controls were compared.

RESULTS

Global radial strain measured on the short-axis slice (GRS-SAX) (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.02-1.15; P < 0.01), global longitudinal strain measured on the long-axis slice (GLS-LAX) (OR, 1.81; 95% CI, 1.21-2.73; P < 0.01) and GRS measured on the long-axis slice (GRS-LAX) (OR, 1.07; 95% CI, 1.01-1.13; P = 0.02) were independent predictors of LVOTO. The combination of GRS-SAX plus GLS-LAX and GRS-LAX showed great discriminatory power for identifying LVOTO with an area under the receiver operating characteristic curve value of 0.91 (95% CI: 0.81-1.00).

CONCLUSIONS

In adult HCM patients, GRS-SAX, GLS-LAX, and GRS-LAX were independent predictors of LVOTO. The combination of GRS-SAX plus GLS-LAX and GRS-LAX showed great discriminatory power for identifying LVOTO.

摘要

目的

确定肥厚型心肌病(HCM)患者左心室(LV)心肌力学与 LV 流出道梗阻(LVOTO)的相关性。

方法

39 例 HCM 成人患者和 21 例对照者接受心血管磁共振检查。对比 HCM 患者中伴或不伴 LVOTO 者与对照者的特征追踪(FT)分析结果。

结果

短轴层面的整体径向应变(GRS-SAX)(比值比[OR],1.09;95%置信区间[CI],1.02-1.15;P<0.01)、长轴层面的整体纵向应变(GLS-LAX)(OR,1.81;95% CI,1.21-2.73;P<0.01)和长轴层面的 GRS(GRS-LAX)(OR,1.07;95% CI,1.01-1.13;P=0.02)是 LVOTO 的独立预测因子。GRS-SAX 加 GLS-LAX 和 GRS-LAX 的组合对识别 LVOTO 具有很好的判别能力,受试者工作特征曲线下面积值为 0.91(95% CI:0.81-1.00)。

结论

在成年 HCM 患者中,GRS-SAX、GLS-LAX 和 GRS-LAX 是 LVOTO 的独立预测因子。GRS-SAX 加 GLS-LAX 和 GRS-LAX 的组合对识别 LVOTO 具有很好的判别能力。

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