应用 CT 斑点追踪技术评估左前降支狭窄患者的左心室局部心肌应变。
Assessment of regional left ventricular myocardial strain in patients with left anterior descending coronary stenosis using computed tomography feature tracking.
机构信息
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
出版信息
BMC Cardiovasc Disord. 2020 Aug 8;20(1):362. doi: 10.1186/s12872-020-01644-5.
BACKGROUND
Computed tomography feature tracking (CT-FT) has emerged as a valuable method for the assessment of cardiac function. However, no studies have investigated the usefulness of CT-derived assessments of left ventricular (LV) strain in coronary artery disease (CAD). Our aim was to evaluate regional LV systolic deformation in patients with left anterior descending coronary artery (LAD) stenosis using CT-FT.
METHODS
Seventy-six patients with LAD stenosis were enrolled. The patients were divided into four groups according to the percentage of LAD stenosis: ≤25% was defined as group I (24 patients), 26 to 49% as group II (17 patients), 50 to 74% as group III (21 patients), and ≥ 75% as group IV (14 patients). Thirty-two sex- and age-matched healthy subjects were included as controls.
RESULTS
No intergroup differences were found between groups I-IV and the controls in terms of the left ventricular ejection fraction, end-diastolic volume and end-systolic volume. However, the longitudinal strain (LS) of the LAD territory was significantly reduced in groups I-IV compared with the controls (- 20.8, - 18.6%, - 18.6%, and - 17.0% vs - 23.7%, respectively). The circumferential strain (CS) of the LAD territory was significantly reduced in groups III and IV compared with the controls and groups I and II (- 22.4% and - 22.1% vs - 25.4, - 24.1%, and - 25.3%, respectively). Compared with the non-LAD territory, the LAD territory in groups II-IV showed significantly increased LS (- 18.6% vs - 21.9%, p = 0.07; - 18.6% vs - 21.9%, p = 0.024; - 17.5% vs - 20%, p = 0.032, respectively). The severity of LAD stenosis was positively correlated with the LS of the LAD territory (r = 0.438, p = 0.002).
CONCLUSION
CT-FT can detect decreasing LV systolic function in patients with LAD stenosis. LV regional systolic deformation of the LAD territory was reduced with increasing LAD stenosis severity.
背景
计算机断层扫描特征追踪（CT-FT）已成为评估心功能的一种有价值的方法。然而，目前还没有研究探讨 CT 衍生的左心室（LV）应变评估在冠状动脉疾病（CAD）中的作用。我们的目的是使用 CT-FT 评估左前降支（LAD）狭窄患者的左心室局部收缩变形。
方法
共纳入 76 例 LAD 狭窄患者。根据 LAD 狭窄程度将患者分为四组：≤25%为 I 组（24 例），26-49%为 II 组（17 例），50-74%为 III 组（21 例），≥75%为 IV 组（14 例）。同时纳入 32 名性别和年龄匹配的健康受试者作为对照组。
结果
I-IV 组与对照组之间在左心室射血分数、舒张末期容积和收缩末期容积方面无组间差异。然而，与对照组相比，I-IV 组 LAD 区域的纵向应变（LS）明显降低（-20.8%、-18.6%、-18.6%和-17.0% vs -23.7%）。与对照组和 I 组、II 组相比，III 组和 IV 组 LAD 区域的圆周应变（CS）明显降低（-22.4%和-22.1% vs -25.4%、-24.1%和-25.3%）。与非 LAD 区域相比，II-IV 组的 LAD 区域 LS 明显增加（-18.6% vs -21.9%，p=0.07；-18.6% vs -21.9%，p=0.024；-17.5% vs -20%，p=0.032）。LAD 狭窄程度与 LAD 区域 LS 呈正相关（r=0.438，p=0.002）。
结论
CT-FT 可检测出 LAD 狭窄患者左心室收缩功能下降。随着 LAD 狭窄程度的增加，LAD 区域的左心室局部收缩变形减少。
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