Wang Y, Lin L, Cao J, Li X, Wang J, Jing Z C, Jin Z Y, Wang Y N
Department of Radiology, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Department of Cardiology, State Key Laboratory of Complex Severe and Rare Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2022 Oct 11;102(37):2963-2968. doi: 10.3760/cma.j.cn112137-20220405-00703.
To explore the application value of cardiac magnetic resonance (CMR) native T mapping for risk stratification in patients with pulmonary arterial hypertension (PAH). A total of 59 patients with diagnosed PAH and clear-documented risk status in Peking Union Medical College Hospital and underwent CMR examination between January 2019 and December 2021 were retrospectively included, which including 12 males and 47 females, aged from 4 to 77 (31±13) years. Those patients were subdivided into two groups based on the clinically-assessed risk status: low-risk group (=30) and intermediate-/high-risk group (=29). Twenty-five healthy individuals were included as controls. Base, midventricular, and apical inferior right ventricular insertion point (IRVIP) native T values on short axis images were measured. Native T1 values in PAH patients and control group, in low-risk group and intermediate-/high-risk group were compared, respectively, and receiver operating characteristics (ROC) curves with area under the curves (AUC) were calculated to evaluate the application value of native T values for risk stratification in PAH patients. Base, midventricular and apical IRVIP native T of PAH patients were all significantly increased as compared to controls [Base:(1 439.31±129.96) vs (1 282.36±37.18) ms;midventricular:(1 450.32±111.55) vs (1 287.56±53.16) ms;apical:(1 444.12±109.15) vs (1 266.36±75.31) ms](all <0.001). The midventricular IRVIP native T values were significantly higher in patients in intermediate-/high-risk status as compared to those in low-risk status [ (1 493.24±126.32) vs (1 428.50±85.73) ms,0.026]. The AUC of mid ventricle IRVIP native T for distinguishing patients in intermediate-/high-risk status was 0.741. The base [(1 458.21±134.96) vs (1 421.03±104.75) ms, =0.241] and apical [(1 465.90±125.36) vs (1 423.07±87.87) ms,=0.136] IRVIP native T1 values in patients in intermediate-/high-risk group were also numerically higher as compared with patients in low-risk status, however, without statistical significant (both >0.05). Midventricular IRVIP native T value might have a role for assisting in risk stratification in PAH patients, which was clinically significant for facilitating the work-up and prognosis improvement of PAH patients.
探讨心脏磁共振成像（CMR）的固有T值映射在肺动脉高压（PAH）患者危险分层中的应用价值。回顾性纳入2019年1月至2021年12月在北京协和医院诊断为PAH且风险状态记录明确并接受CMR检查的59例患者，其中男性12例，女性47例，年龄4至77（31±13）岁。根据临床评估的风险状态将这些患者分为两组：低风险组（n = 30）和中/高风险组（n = 29）。纳入25名健康个体作为对照。测量短轴图像上的心底、心室中部和心尖下右心室插入点（IRVIP）的固有T值。分别比较PAH患者与对照组、低风险组与中/高风险组的固有T1值，并计算曲线下面积（AUC）的受试者操作特征（ROC）曲线，以评估固有T值在PAH患者危险分层中的应用价值。与对照组相比，PAH患者的心底、心室中部和心尖IRVIP固有T值均显著升高[心底：（1439.31±129.96）vs（1282.36±37.18）ms；心室中部：（1450.32±111.55）vs（1287.56±53.16）ms；心尖：（1444.12±109.15）vs（1266.36±75.31）ms]（均P<0.001）。中/高风险状态患者的心室中部IRVIP固有T值显著高于低风险状态患者[（1493.24±126.32）vs（1428.50±85.73）ms，P = 0.026]。心室中部IRVIP固有T值区分中/高风险状态患者的AUC为0.741。中/高风险组患者的心底[（1458.21±134.96）vs（1421.03±104.75）ms，P = 0.241]和心尖[（1465.90±125.36）vs（1423.07±87.87）ms，P = 0.136]IRVIP固有T1值在数值上也高于低风险状态患者，但无统计学意义（均P>0.05）。心室中部IRVIP固有T值可能有助于PAH患者的危险分层，这对促进PAH患者的检查和改善预后具有临床意义。
