Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, 20# Section 3 South Renmin Road, Chengdu, 610041, China.
Department of Radiology, Deyang People's Hospital, 173# Section 3 Tai Shan Road, Deyang, 618400, Sichuan, China.
Sci Rep. 2021 Feb 25;11(1):4616. doi: 10.1038/s41598-021-84233-6.
This study evaluated the effects of mitral regurgitation (MR) on cardiac structure and function in left ventricular noncompaction (LVNC) patients. The clinical and cardiovascular magnetic resonance (CMR) data for 182 patients with noncompaction or hypertrabeculation from three institutes were retrospectively included. We analyzed the difference in left ventricular geometry, cardiac function between LVNC patients with and without MR. The results showed that patients with MR had a worse New York Heart Association (NYHA) class and a higher incidence of arrhythmia (P < 0.05). MR occurred in 48.2% of LVNC patients. Compared to LVNC patients without MR, the two-dimensional sphericity index, maximum/minimum end-diastolic ratio and longitudinal shortening in LVNC patients with MR were lower (P < 0.05), and the peak longitudinal strain (PLS) of the global and segmental myocardium were obviously reduced (P < 0.05). No significant difference was found in strain in LVNC patients with different degree of MR; end diastolic volume, end systolic volume, and global PLS were statistically associated with MR and NYHA class (P < 0.05), but the non-compacted to compacted myocardium ratio had no significant correlation with them. In conclusion, the presence of MR is common in LVNC patients. LVNC patients with MR feature more severe morphological and functional changes. Hypertrabeculation is not an important factor affecting structure and function at the heart failure stage.
这项研究评估了二尖瓣反流(MR)对左心室心肌致密化不全(LVNC)患者心脏结构和功能的影响。回顾性纳入了来自三个研究所的 182 名非致密化或心肌肥厚患者的临床和心血管磁共振(CMR)数据。我们分析了伴或不伴 MR 的 LVNC 患者左心室几何形状和心功能的差异。结果显示,MR 患者的纽约心脏病协会(NYHA)心功能分级更差,心律失常发生率更高(P<0.05)。MR 发生于 48.2%的 LVNC 患者中。与无 MR 的 LVNC 患者相比,MR 的 LVNC 患者二维球形指数、最大/最小舒张末期比和左心室纵向缩短率较低(P<0.05),整体和节段心肌的峰值纵向应变(PLS)明显降低(P<0.05)。不同程度 MR 的 LVNC 患者的应变无明显差异;舒张末期容积、收缩末期容积和整体 PLS 与 MR 和 NYHA 心功能分级相关(P<0.05),但非致密心肌与致密心肌比值与它们无显著相关性。总之,MR 在 LVNC 患者中很常见。伴 MR 的 LVNC 患者表现出更严重的形态和功能改变。在心力衰竭阶段,心肌肥厚不是影响结构和功能的重要因素。