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类风湿关节炎患者中通过心脏磁共振特征追踪评估左心室心肌应变

Left ventricular myocardial strain assessed by cardiac magnetic resonance feature tracking in patients with rheumatoid arthritis.

作者信息

Tański Wojciech, Gać Paweł, Chachaj Angelika, Mazur Grzegorz, Poręba Rafał, Szuba Andrzej

机构信息

Department of Internal Medicine, 4Th Military Hospital, Weigla 5, 50-981, Wroclaw, Poland.

Centre for Diagnostic Imaging, 4Th Military Hospital, Weigla 5, 50-981, Wroclaw, Poland.

出版信息

Insights Imaging. 2021 Jan 7;12(1):5. doi: 10.1186/s13244-020-00948-6.

Abstract

PURPOSE

The aim of the study was to assess a relationship between the occurrence of rheumatoid arthritis (RA) and its selected clinical parameters, and left ventricular myocardial strain.

MATERIAL AND METHODS

Fifty-six subjects were qualified for the study: 30 RA patients and 26 subjects without rheumatoid diseases. The study design included taking medical history, assessment of the disease activity using selected scales of activity, collecting samples of venous blood to assess selected laboratory parameters and the assessment of cardiac magnetic resonance (CMR). Using the feature tracking method, the following parameters of the left ventricular myocardial strain were assessed: longitudinal strain (LS), radial strain (RS) and circumferential strain (CS).

RESULTS

Regarding global values, peak LS and peak CS were statistically significantly lower in RA patients than in the control group. In the whole study group, the factors independently related to low global LS peaks were as follows: occurrence of RA, occurrence of arterial hypertension, increased activity of antibodies against cyclic citrullinated peptide and increased concentration of neutrophil gelatinase-associated lipocalin. The occurrence of RA, occurrence of diabetes, tobacco smoking, higher activity of antibodies against cyclic citrullinated peptide and current use of methotrexate are the risk factors for low peak of global CS. The current use of steroids constitutes a protecting factor against low global CS peaks.

CONCLUSION

In subjects with no clinically manifested cardiac damage, RA is associated with a deteriorated left ventricular systolic function assessed by left ventricular myocardial strain measured by CMR feature tracking.

摘要

目的

本研究旨在评估类风湿关节炎(RA)的发生与其选定的临床参数以及左心室心肌应变之间的关系。

材料与方法

56名受试者符合研究条件:30名RA患者和26名无类风湿疾病的受试者。研究设计包括采集病史、使用选定的活动量表评估疾病活动度、采集静脉血样本以评估选定的实验室参数以及进行心脏磁共振(CMR)评估。采用特征追踪法评估左心室心肌应变的以下参数:纵向应变(LS)、径向应变(RS)和圆周应变(CS)。

结果

就整体值而言,RA患者的LS峰值和CS峰值在统计学上显著低于对照组。在整个研究组中,与低整体LS峰值独立相关的因素如下:RA的发生、动脉高血压的发生、抗环瓜氨酸肽抗体活性增加以及中性粒细胞明胶酶相关脂质运载蛋白浓度升高。RA的发生、糖尿病的发生、吸烟、抗环瓜氨酸肽抗体活性较高以及当前使用甲氨蝶呤是整体CS峰值较低的危险因素。当前使用类固醇是防止整体CS峰值降低的保护因素。

结论

在无临床表现的心脏损害的受试者中,RA与通过CMR特征追踪测量的左心室心肌应变评估的左心室收缩功能恶化有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ed/7790980/5076a8974170/13244_2020_948_Fig5_HTML.jpg

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