Pruijssen Judith T, Allen Bradley D, Barker Alex J, Bonow Robert O, Choudhury Lubna, Carr James C, Markl Michael, van Ooij Pim
Department of Biomedical Engineering and Physics (J.T.P.) and Department of Radiology & Nuclear Medicine (P.v.O.), Academic Medical Center, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiology (B.D.A., J.C.C., M.M.), Department of Medicine-Cardiology (R.O.B., L.C.), and Department of Biomedical Engineering (M.M.), Northwestern University, Chicago, Ill; and Department of Radiology & Bioengineering, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Denver, Colo (A.J.B.).
Radiol Cardiothorac Imaging. 2020 Feb 27;2(1):e190038. doi: 10.1148/ryct.2020190038. eCollection 2020 Feb.
To employ four-dimensional (4D) flow MRI to investigate associations between hemodynamic parameters with systolic anterior motion (SAM), mitral regurgitation (MR), stroke volume, and cardiac mass in patients with hypertrophic cardiomyopathy (HCM).
A total of 13 patients with HCM (51 years ± 16 [standard deviation]; 10 men) and 11 age-matched healthy control subjects (54 years ± 15; eight men) underwent cardiac 4D flow MRI data analysis including calculation of peak systolic and diastolic control-averaged left ventricular (LV) velocity maps to quantify volumes of elevated velocity (EVV) in the left ventricle. Standard-of-care cine imaging was performed in short-axis, LV outflow tract (LVOT), and two-, three-, and four-chamber views on which the presence of SAM, presence of MR, total stroke volume, and cardiac mass were assessed.
Systolic EVV in patients with HCM was 7 mL ± 5, which was significantly associated with elevated aortic peak velocity ( = 0.87; < .001), decreased LVOT diameter ( = 0.68; = .01), and increased cardiac mass ( = 0.62; = .02). In addition, EVV differed significantly between patients with and those without SAM (10 mL ± 4.7 vs 3 mL ± 2.3; = .03) and those with and those without MR (9.9 mL ± 4.8 vs 4.0 mL ± 3.2; < .05). In the atrial systolic phase, peak diastolic velocity in the LV correlated with septal thickness ( = 0.66; = .01).
Quantification and visualization of EVV in the LV is feasible and may provide further insight into the clinical manifestations of altered hemodynamics in HCM.© RSNA, 2020.
采用四维（4D）血流磁共振成像（MRI）研究肥厚型心肌病（HCM）患者血流动力学参数与收缩期前向运动（SAM）、二尖瓣反流（MR）、每搏输出量和心脏质量之间的关联。
共有13例HCM患者（年龄51岁±16岁[标准差]；男性10例）和11例年龄匹配的健康对照者（年龄54岁±15岁；男性8例）接受心脏4D血流MRI数据分析，包括计算收缩期峰值和舒张期平均左心室（LV）速度图，以量化左心室内高速血流容积（EVV）。在短轴、左心室流出道（LVOT）以及两腔、三腔和四腔视图上进行标准的心脏电影成像，评估SAM的存在、MR的存在、总每搏输出量和心脏质量。
HCM患者的收缩期EVV为7 mL±5，与主动脉峰值速度升高显著相关（r = 0.87；P <.001），LVOT直径减小（r = 0.68；P =.01），心脏质量增加（r = 0.62；P =.02）。此外，有SAM和无SAM的患者之间EVV差异显著（10 mL±4.7 vs 3 mL±2.3；P =.03），有MR和无MR的患者之间也有显著差异（9.9 mL±4.8 vs 4.0 mL±3.2；P <.05）。在心房收缩期，LV的舒张期峰值速度与室间隔厚度相关（r = 0.66；P =.01）。
LV内EVV的量化和可视化是可行的，可能为深入了解HCM血流动力学改变的临床表现提供进一步的见解。©RSNA，2020。
