Wang Jin, Gao Yue, Yang Zhi-Gang, Guo Ying-Kun, Jiang Li, Shi Rui, Xu Hua-Yan, Huang Shan, Li Yuan
Department of Radiology, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
Department of Radiology, Key Laboratory of Obstetric & Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, 20# Section 3, Renmin South Road, Chengdu, 610041, Sichuan, China.
Int J Cardiovasc Imaging. 2022 Jul;38(7):1545-1554. doi: 10.1007/s10554-022-02539-6. Epub 2022 Mar 13.
The aim of this study was to evaluate left ventricular (LV) myocardial involvement in connective tissue disease (CTD) patients using multiparemetric imaging derived from cardiovascular magnetic resonance (CMR). CMR was performed on 146 CTD patients (comprising of 74 with idiopathic inflammatory myopathy (IIM) and 72 with non-IIM) and 72 healthy controls and included measures of LV global strains [including peak strain (PS), peak systolic (PSSR) and diastolic strain rate (PDSR)], myocardial perfusion [including upslope, max signal intensity (MaxSI), and time to maximum signal intensity (TTM)], and late gadolinium enhancement (LGE) parameters. Univariable and multivariable linear regression analyses were performed to determine the association between LV deformation and microvascular perfusion, as well as LGE. Our results indicated that CTD patients had decreased global longitudinal PS (GLPS), PSSR, PDSR, and myocardial perfusion (all p < 0.017) compared with normal controls. Non-IIM patients exhibited lower LV global strain and longer TTM than IIM patients. The presence of LGE was independently associated with global radial PS (GRPS: β = - 0.165, p = 0.011) and global circumferential PS (GCPS: β = - 0.122, p = 0.022). TTM was independently correlated with GLPS (β = - 0.156, p = 0.027). GLPS was the best indicator for differentiating CTD patients from normal controls (area under curve of 0.78). This study indicated that CTD patients showed impaired LV global myocardial deformation and microvascular perfusion, and presence of LGE. Cardiac involvement might be more severe in non-IIM patients than in IIM patients. Impaired microvascular perfusion and the presence of LGE were independently associated with LV global deformation.
本研究的目的是使用源自心血管磁共振（CMR）的多参数成像来评估结缔组织病（CTD）患者的左心室（LV）心肌受累情况。对146例CTD患者（包括74例特发性炎性肌病（IIM）患者和72例非IIM患者）以及72例健康对照者进行了CMR检查，检查内容包括左心室整体应变[包括峰值应变（PS）、峰值收缩期应变率（PSSR）和舒张期应变率（PDSR）]、心肌灌注[包括上升斜率、最大信号强度（MaxSI）和达到最大信号强度的时间（TTM）]以及延迟钆增强（LGE）参数。进行单变量和多变量线性回归分析，以确定左心室变形与微血管灌注以及LGE之间的关联。我们的结果表明，与正常对照相比，CTD患者的整体纵向PS（GLPS）、PSSR、PDSR和心肌灌注均降低（所有p<0.017）。非IIM患者的左心室整体应变低于IIM患者，TTM长于IIM患者。LGE的存在与整体径向PS（GRPS：β=-0.165，p=0.011）和整体圆周PS（GCPS：β=-0.122，p=0.022）独立相关。TTM与GLPS独立相关（β=-0.156，p=0.027）。GLPS是区分CTD患者与正常对照的最佳指标（曲线下面积为0.78）。本研究表明，CTD患者存在左心室整体心肌变形和微血管灌注受损以及LGE。非IIM患者的心脏受累可能比IIM患者更严重。微血管灌注受损和LGE的存在与左心室整体变形独立相关。
