Zhang He, Tian Zhaoxin, Huo Huaibi, Li Han, Liu Hui, Hou Yang, Dai Xu, Liu Ting, Jin Shiqi
Department of Radiology, The First Hospital of China Medical University, Shenyang 110001, China.
Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110001, China.
J Clin Med. 2022 Nov 24;11(23):6938. doi: 10.3390/jcm11236938.
Background: LA function has been recognized as a significant prognostic marker in many cardiovascular diseases. Cardiovascular magnetic resonance feature tracking (CMR-FT) represents a promising technique for left atrial function evaluation. The size and location of myocardial infarction are important factors in the cause of adverse left ventricular remodeling, but the effect on the left atriam is unclear. Purpose: to investigate the effect of location and size of previous myocardial infarction (MI) on LA function using CMR-FT. Study type: retrospective. Population: patients formerly diagnosed with anterior MI (n = 42) or non-anterior MI (n = 40) and healthy controls (n = 47). Field Strength/Sequence: a 3.0T MR, Steady state free precession (SSFP), Phase-sensitive inversion recovery (PSIR). Assessment: infarct location and size were assigned and quantified by late-gadolinium enhancement (LGE) imaging. LA performance was analyzed using CMR-FT in 2- and 4-chamber cine images, including LA reservoir, conduit and booster pump function. Statistics: descriptive statistics, ANOVA with post Bonferroni correction, Kruskal−Wallis H, Spearman’s correlation, intraclass correlation coefficient. Results: Anterior MI patients had impaired LA reservoir function (LATEF, εs, SRs), conduit function (LAPEF, εe, SRs) and booster pump function (LAAEF, εa) compared with controls (p < 0.05). Non-anterior MI patients had impaired LA strain (εs, εe, εa; p < 0.05) but preserved LAEFs (p > 0.05). After adjusting the area of MI, there was no significant difference in the LA morphology and function between the anterior and non-anterior wall groups. Stratification analysis by MI size revealed that LA volumes and LAEFs were unchanged in patients with MI size ≤ 15% compared with controls (p > 0.05); only εs and εe were decreased (p < 0.05). Increased LAVIpre-a, LAVImin and decreased LATEF, and LAAEF were found in patients with MI size > 15% compared with the MI size ≤ 15% group (p < 0.05). LVSVI, εs and MI size were significant correlated with LAVI pre-a in multiple stepwise regression analysis. Data conclusions: The location of myocardial infarction is not a major factor affecting the morphology and function of the left atrium. Patients with MI size > 15% experience more pronounced post-infarction LA remodeling and dysfunction than MI size ≤ 15% patients.
左心房功能已被公认为多种心血管疾病的重要预后指标。心血管磁共振特征追踪（CMR-FT）是一种用于评估左心房功能的有前景的技术。心肌梗死的大小和位置是导致不良左心室重构的重要因素，但对左心房的影响尚不清楚。目的：使用CMR-FT研究既往心肌梗死（MI）的位置和大小对左心房功能的影响。研究类型：回顾性研究。研究对象：既往诊断为前壁心肌梗死（n = 42）或非前壁心肌梗死（n = 40）的患者以及健康对照者（n = 47）。场强/序列：3.0T磁共振成像，稳态自由进动（SSFP）序列，相位敏感反转恢复（PSIR）序列。评估：通过延迟钆增强（LGE）成像确定并量化梗死灶的位置和大小。在二腔心和四腔心电影图像中使用CMR-FT分析左心房功能，包括左心房储存功能、管道功能和助力泵功能。统计学方法：描述性统计、采用Bonferroni校正的方差分析、Kruskal-Wallis H检验、Spearman相关性分析、组内相关系数分析。结果：与对照组相比，前壁心肌梗死患者的左心房储存功能（LATEF、εs、SRs）、管道功能（LAPEF、εe、SRs）和助力泵功能（LAAEF、εa）受损（p < 0.05）。非前壁心肌梗死患者的左心房应变（εs、εe、εa；p < 0.05）受损，但左心房射血分数保留（p > 0.05）。在调整心肌梗死面积后，前壁和非前壁心肌梗死组之间的左心房形态和功能无显著差异。按心肌梗死大小进行分层分析显示，与对照组相比，心肌梗死面积≤15%的患者左心房容积和左心房射血分数无变化（p > 0.05）；仅εs和εe降低（p < 0.05）。与心肌梗死面积≤15%组相比，心肌梗死面积> 15%的患者LAVIpre-a、LAVImin升高，LATEF和LAAEF降低（p < 0.05）。在多元逐步回归分析中，左心室每搏量指数、εs和心肌梗死大小与LAVI pre-a显著相关。数据结论：心肌梗死的位置不是影响左心房形态和功能的主要因素。心肌梗死面积> 15%的患者比心肌梗死面积≤15%的患者经历更明显的梗死后左心房重构和功能障碍。
