Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.
Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Clin Physiol Funct Imaging. 2022 Nov;42(6):413-421. doi: 10.1111/cpf.12780. Epub 2022 Jul 26.
In patients with coronary artery disease (CAD), ischaemic cardiomyopathy may result in progressive cardiac remodelling and left ventricular (LV) dysfunction. Myocardial perfusion imaging (MPI) can be used to quantify LV size and shape, mechanical dyssynchrony (LVMD) and ejection fraction (EF) as well as myocardial ischaemia and injury extents. We investigated the prevalence of LV remodelling (LVR) in patients with CAD and the relationship between LVR, LVMD and EF.
Three hundred twenty-six patients with CAD were evaluated. The EF and end-diastolic volume (EDV) were measured using MPI. LVMD was assessed using phase analysis. LVR was characterised according to LV dilatation or increased shape indices (systolic shape index [SIES] and diastolic shape index [SIED]).
LVR were observed in 41% of CAD patients. EDV, SIES and SIED were larger in patients with LVMD or low EF. After adjustment for age, sex and infarct and ischaemia extents, phase histogram bandwidth correlated with EDV (r = 0.218) and SIES (r = 0.266) and EF correlated with EDV (r = -0.535), SIES (r = -0.554) and SIED (r = -0.217, p < 0.001 for all).
LVR is frequently seen in patients with CAD and may be detected even before the development of symptomatic heart failure. A large LV volume and a more spherical-shaped LV were associated with LVMD and low EF, highlighting the close relationships between remodelling and systolic dyssynchrony and dysfunction. MPI is useful for assessing LVR by providing information about LV size and shape, which changes from an ellipsoid towards a spherical form in the development of ischaemic cardiomyopathy.
在患有冠状动脉疾病 (CAD) 的患者中，缺血性心肌病可能导致进行性心脏重构和左心室 (LV) 功能障碍。心肌灌注成像 (MPI) 可用于定量 LV 大小和形状、机械不同步 (LVMD) 和射血分数 (EF) 以及心肌缺血和损伤程度。我们研究了 CAD 患者 LV 重构 (LVR) 的患病率以及 LVR、LVMD 和 EF 之间的关系。
评估了 326 例 CAD 患者。使用 MPI 测量 EF 和舒张末期容积 (EDV)。使用相位分析评估 LVMD。根据 LV 扩张或增加的形状指数 (收缩期形状指数 [SIES] 和舒张期形状指数 [SIED]) 来描述 LVR。
41%的 CAD 患者存在 LVR。LVMD 或 EF 较低的患者 EDV、SIES 和 SIED 较大。在校正年龄、性别、梗死和缺血程度后，相位直方图带宽与 EDV 相关 (r=0.218) 和 SIES (r=0.266) 和 EF 与 EDV 相关 (r=-0.535)、SIES (r=-0.554) 和 SIED (r=-0.217，p<0.001)。
LVR 在 CAD 患者中很常见，甚至在出现症状性心力衰竭之前就可能被发现。大的 LV 容积和更球形的 LV 与 LVMD 和 EF 较低相关，突出了重构与收缩不同步和功能障碍之间的密切关系。MPI 通过提供有关 LV 大小和形状的信息，可用于评估 LVR，这些信息在缺血性心肌病的发展过程中，LV 从椭圆形向球形转变。
