Tang Si-Shi, Shi Rui, Yang Zhi-Gang, Wang Jin, Min Chen-Yan, Yan Wei-Feng, Zhang Yi, Li Yuan
Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Radiology, Chengdu Fifth People's Hospital, Chengdu, Sichuan, China.
J Magn Reson Imaging. 2023 Oct;58(4):1125-1136. doi: 10.1002/jmri.28604. Epub 2023 Feb 2.
Mitral regurgitation may occur when hypertension causes left ventricular (LV) and left atrial (LA) remodeling. However, its role in LA function in hypertensive patients remains unclear.
To explore how mitral regurgitation affects LA function in hypertension and to investigate atrioventricular interaction in hypertensive patients with mitral regurgitation.
Retrospective.
A total of 193 hypertensive cases and 64 controls.
FIELD STRENGTH/SEQUENCE: A 3.0 T/balanced steady-state free precession.
LA volume (LAV), LA strain (reservoir, conduit, and active), LA ejection fraction, and LV strain (global peak longitudinal [GLS], circumferential [GCS], and radial strain [GRS]) were evaluated and compared among groups. Regurgitant fraction (RF) was evaluated in regurgitation patients and used to subdivide patients into mild (RF: 0%-30%), moderate (RF: 30%-50%), and severe (RF: >50%) regurgitation categories.
One-way analysis of variance, Spearman and Pearson's correlation coefficients (r), and multivariable linear regression analysis. A P value <0.05 was considered statistically significant.
Hypertensive patients without mitral regurgitation showed significantly impaired LA reservoir and conduit functions and significantly decreased LV GLS but preserved pump function and LAV compared to controls (P = 0.193-1.0). Hypertensive cases with mild regurgitation (N = 22) had significantly enlarged LAV and further reduced LA reservoir function, while the group with moderate regurgitation (N = 20) showed significantly reduced LA pump function, further impaired conduit function, and significantly reduced LV strain. The severe regurgitation (N = 13) group demonstrated significantly more severely impaired LA and LV functions and LAV enlargement. Multivariable linear regression showed that regurgitation degree, GRS, GCS, and GLS were independently correlated with the LA reservoir, conduit, and active strain in hypertensive patients with mitral regurgitation.
Mitral regurgitation may exacerbate LA and LV impairment in hypertension. Regurgitation degree, LV GRS, GCS, and GLS were independent determinants of the LA strain in hypertensive patients with mitral regurgitation, which demonstrated atrioventricular interaction.
Stage 3.
高血压导致左心室（LV）和左心房（LA）重塑时可能会发生二尖瓣反流。然而，其在高血压患者左心房功能中的作用仍不清楚。
探讨二尖瓣反流如何影响高血压患者的左心房功能，并研究二尖瓣反流高血压患者的房室相互作用。
回顾性研究。
共193例高血压患者和64例对照者。
场强/序列：3.0 T/平衡稳态自由进动序列。
评估并比较各组的左心房容积（LAV）、左心房应变（储存、管道和主动应变）、左心房射血分数以及左心室应变（整体峰值纵向应变[GLS]、圆周应变[GCS]和径向应变[GRS]）。对反流患者评估反流分数（RF），并用于将患者分为轻度（RF：0%-30%）、中度（RF：30%-50%）和重度（RF：>50%）反流类别。
单因素方差分析、Spearman和Pearson相关系数（r）以及多变量线性回归分析。P值<0.05被认为具有统计学意义。
与对照组相比，无二尖瓣反流的高血压患者左心房储存和管道功能显著受损，左心室GLS显著降低，但泵功能和LAV保持正常（P = 0.193 - 1.0）。轻度反流的高血压患者（N = 22）LAV显著增大，左心房储存功能进一步降低，而中度反流组（N = 20）左心房泵功能显著降低，管道功能进一步受损，左心室应变显著降低。重度反流组（N = 13）左心房和左心室功能受损更严重，LAV增大。多变量线性回归显示，在二尖瓣反流高血压患者中，反流程度、GRS、GCS和GLS与左心房储存、管道和主动应变独立相关。
二尖瓣反流可能会加重高血压患者的左心房和左心室损害。反流程度、左心室GRS、GCS和GLS是二尖瓣反流高血压患者左心房应变的独立决定因素，表明存在房室相互作用。
4级。
3级。
