Liu Wangyan, Zhu Yinsu, Feng Changjing, Zhu Xiaomei, Xu Yi, Shi Haibin
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu, China.
Int J Cardiovasc Imaging. 2023 Jan;39(1):183-194. doi: 10.1007/s10554-022-02715-8. Epub 2022 Sep 16.
Cardiac involvement is common in idiopathic inflammatory myopathy (IIM) but often subclinical. Cardiac magnetic resonance (CMR) is a promising tool in detecting cardiac involvement in patients with IIM. The aim of this study was to assess cardiac involvement in IIM patients by CMR feature tracking (CMR-FT). Thirty-seven IIM patients and 25 controls were enrolled in this retrospective study. The left ventricular (LV) functional parameters such as volume and ejection fraction were measured. Global and regional LV peak strain (PS) in radial, circumferential and longitudinal directions were derived from cine images. Left atrial (LA) volume, longitudinal strain and strain rate (SR) parameters and LA reservoir function, conduit function and booster pump function were assessed, respectively. IIM patients with preserved LVEF showed significantly reduced global and regional LV PS in longitudinal direction (all p < 0.05). Compared with controls, LA reservoir and conduit function were significantly impaired in IIM patients (all p < 0.05). The global LV longitudinal PS, LAVpre-ac and SRe were independent predictors of IIM. By Pearson's correlation analysis, the LV global radial, circumferential and longitudinal PS were all correlated to LVEF in IIM patients (r = 0.526, p < 0.001 vs. r = - 0.514, p < 0.001 vs. r = - 0.288, p = 0.023). CMR-FT based LV and LA deformation performance could early detect cardiac involvement in IIM patients with preserved LVEF.
心脏受累在特发性炎性肌病(IIM)中很常见,但往往是亚临床的。心脏磁共振成像(CMR)是检测IIM患者心脏受累的一种很有前景的工具。本研究的目的是通过CMR特征追踪(CMR-FT)评估IIM患者的心脏受累情况。37例IIM患者和25例对照纳入了这项回顾性研究。测量了左心室(LV)的功能参数,如容积和射血分数。从电影图像中得出左心室在径向、圆周和纵向方向的整体和局部峰值应变(PS)。分别评估了左心房(LA)容积、纵向应变和应变率(SR)参数以及LA的储器功能、管道功能和增压泵功能。左心室射血分数保留的IIM患者在纵向方向上的整体和局部左心室PS显著降低(所有p<0.05)。与对照组相比,IIM患者的LA储器和管道功能明显受损(所有p<0.05)。左心室整体纵向PS、左心房预负荷前容积和应变率是IIM的独立预测因素。通过Pearson相关分析,IIM患者左心室整体径向、圆周和纵向PS均与左心室射血分数相关(r=0.526,p<0.001;r=-0.514,p<0.001;r=-0.288,p=0.023)。基于CMR-FT的左心室和左心房变形性能可早期检测左心室射血分数保留的IIM患者的心脏受累情况。