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左心室功能不同恶化程度时应变参数的变化:左心室致密化不全患者的心脏磁共振特征追踪研究。

Changes in strain parameters at different deterioration levels of left ventricular function: A cardiac magnetic resonance feature-tracking study of patients with left ventricular noncompaction.

机构信息

Heart and Vascular Center of Semmelweis University, Budapest, Hungary.

Heart and Vascular Center of Semmelweis University, Budapest, Hungary.

出版信息

Int J Cardiol. 2021 May 15;331:124-130. doi: 10.1016/j.ijcard.2021.01.072. Epub 2021 Feb 9.

DOI:10.1016/j.ijcard.2021.01.072
PMID:33577906
Abstract

BACKGROUND

There is a lack of cardiac MRI information on left ventricular (LV) strain and rotational parameters of left ventricular noncompaction (LVNC) patients with reduced ejection fraction (EF). Thus, we sought to use feature tracking (FT) to describe these changes at different levels of EF deterioration.

METHODS

We included 31 adult LVNC patients with reduced LV EF (Group B, EF < 50%) without any comorbidities or concomitant cardiac diseases, 31 age- and sex-matched LVNC patients with good EF (Group A, EF > 50%) and 31 healthy controls. Group B was divided according to LV EF into two subgroups (Group B-1: EF 35-50%, Group B-2: EF < 35%). Their global longitudinal, circumferential (GCS), and radial (GRS) strains; LV segmental strains; LV apical and basal rotation values; and patterns and degree of LV dyssynchrony were measured.

RESULTS

All of the global and mean segmental strain parameters were significantly worse in Groups B, B-1 and B-2 than in Group A and in the controls. The LV mechanical dispersion increased as LV EF decreased. The degree of apical rotation was the highest in the control group, almost the same in Group A and the lowest and in the reverse direction in Group B-2. A rotational pattern, clockwise-directed rigid body rotation (RBR), was found in 39% of the Group B patients, and a counterclockwise-directed RBR was found in 26% of the Group A patients.

CONCLUSIONS

The strain values and rotational parameters changed as the EF decreased. These changes affected the global LV, and we did not identify an LVNC-specific strain pattern.

摘要

背景

左心室射血分数(EF)降低的左心室心肌致密化不全(LVNC)患者的左心室(LV)应变和旋转参数的心脏 MRI 信息有限。因此,我们试图使用特征追踪(FT)来描述 EF 恶化不同程度的这些变化。

方法

我们纳入了 31 名成人左心室心肌致密化不全伴左心室射血分数降低(EF<50%,B 组)的患者,这些患者无任何合并症或伴发心脏病,以及 31 名年龄和性别匹配的左心室射血分数良好(EF>50%,A 组)的左心室心肌致密化不全患者和 31 名健康对照者。B 组根据左心室 EF 进一步分为两个亚组(B-1 组:EF 为 35%-50%;B-2 组:EF<35%)。测量其整体纵向应变、整体圆周应变(GCS)、整体径向应变(GRS)、LV 节段应变、LV 心尖和基底旋转值以及 LV 不同步的模式和程度。

结果

与 A 组和对照组相比,B 组、B-1 组和 B-2 组的所有整体和平均节段应变参数均显著降低。随着 LV EF 降低,LV 机械弥散增加。对照组的心尖旋转程度最高,A 组几乎相同,B-2 组最低且呈反向旋转。B 组患者中有 39%存在旋转模式,为顺时针方向的刚体旋转(RBR),A 组患者中有 26%存在逆时针方向的 RBR。

结论

应变值和旋转参数随 EF 降低而变化。这些变化影响整体 LV,并且我们没有识别出 LVNC 特异性应变模式。

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