Shanghai Institute of Medical Imaging, Shanghai, 200032, China.
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Int J Cardiovasc Imaging. 2022 Sep;38(9):2025-2033. doi: 10.1007/s10554-022-02581-4. Epub 2022 Mar 12.
To determine the relationship between aortic distensibility and left ventricular (LV) remodeling, myocardial strain and blood biomarkers in patients with stenotic bicuspid aortic valve (BAV) and preserved ejection fraction (EF) by cardiovascular magnetic resonance (CMR). 43 stenotic BAV patients were prospectively selected for 3.0 T CMR. Patients were divided into LV remodeling group (LV mass/volume ≥ 1.15, n = 21) and non-remodeling group (LV mass/volume < 1.15, n = 22). Clinical characteristics, biochemical data including cardiac troponin T(cTNT), N-terminal pro-B type natriuretic peptide (NT-proBNP) and creatine kinase isoenzyme (CK-MB) were noted. Distensibility of middle ascending aorta (mid-AA) and proximal descending aorta, LV structural and functional parameters, global and regional myocardial strain were measured. Compared to non-remodeling group, LV remodeling group had significantly decreased LV global strain (radial: 26.04 ± 8.70% vs. 32.92 ± 7.81%, P = 0.009; circumferential: - 17.20 ± 3.38% vs. - 19.65 ± 2.34%, P = 0.008; longitudinal: - 9.13 ± 2.34% vs. - 11.63 ± 1.99%, P < 0.001) and decreased mid-AA distensibility (1.22 ± 0.24 10 mm/Hg vs 1.60 ± 0.41 10 mm/Hg, P = 0.001). In addition, mid-AA distensibility was independently associated with LV remodeling (β = - 0.282, P = 0.003), and it was also significantly correlated with LV global strain (radial: r = 0.392, P = 0.009; circumferential: r = - 0.348, P = 0.022; longitudinal: r = - 0.333, P = 0.029), cTNT (r = - 0.333, P = 0.029) and NT-proBNP (r = - 0.440, P = 0.003). In this cohort with stenotic BAV and preserved EF, mid-AA distensibility is found significantly associated with LV remolding, which encouraging to better understand mechanism of ventricular vascular coupling.
为了通过心血管磁共振（CMR）确定狭窄性二叶式主动脉瓣（BAV）和射血分数保留的患者的主动脉顺应性与左心室（LV）重构、心肌应变和血液生物标志物之间的关系。前瞻性选择 43 例狭窄性 BAV 患者进行 3.0T CMR。患者分为 LV 重构组（LV 质量/体积≥1.15，n=21）和非重构组（LV 质量/体积<1.15，n=22）。记录临床特征、包括心脏肌钙蛋白 T（cTNT）、N 末端脑利钠肽前体（NT-proBNP）和肌酸激酶同工酶（CK-MB）在内的生化数据。测量中升主动脉（mid-AA）和近降主动脉的顺应性、LV 结构和功能参数、整体和区域性心肌应变。与非重构组相比，LV 重构组的 LV 整体应变明显降低（径向：26.04±8.70% vs. 32.92±7.81%，P=0.009；周向：-17.20±3.38% vs. -19.65±2.34%，P=0.008；纵向：-9.13±2.34% vs. -11.63±1.99%，P<0.001）和 mid-AA 顺应性降低（1.22±0.24×10mm/Hg 与 1.60±0.41×10mm/Hg，P=0.001）。此外，mid-AA 顺应性与 LV 重构独立相关（β=-0.282，P=0.003），并且与 LV 整体应变显著相关（径向：r=0.392，P=0.009；周向：r=-0.348，P=0.022；纵向：r=-0.333，P=0.029）、cTNT（r=-0.333，P=0.029）和 NT-proBNP（r=-0.440，P=0.003）。在本研究中，在狭窄性 BAV 和射血分数保留的患者中，发现 mid-AA 顺应性与 LV 重构明显相关，这有助于更好地理解心室血管耦联的机制。
