Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan 200001, Shandong, China.
Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, Jiangsu, China.
Contrast Media Mol Imaging. 2023 Feb 6;2023:5996741. doi: 10.1155/2023/5996741. eCollection 2023.
Strain analysis of cardiac magnetic resonance (CMR) is critical for the diagnosis and prognosis of heart failure (HF) with preserved ejection fraction (HFpEF). Our study aimed to identify the diagnostic and prognostic value of strain analysis revealed by CMR in HFpEF.
Participants in HFpEF and control were recruited according to the guideline. Baseline information, clinical parameters, blood samples were collected, and echocardiography and CMR examination were performed. Various parameters, including global longitudinal strain, global circumferential strain (GCS) and global radial strain in left ventricle (LV), right ventricle (RV), and left atrium, were measured from CMR. Receiver operator curve (ROC) was established to evaluate the diagnostic and prognostic value of strains in HFpEF.
Seven strains, with the exception of RVGCS, were employed to generate ROC curves after -test. All strains had significant diagnostic value for HFpEF. The area under curve (AUC) of LV strains was greater than 0.7 and the AUC of the combined analysis of LV strains was 0.858 (95% confidence interval (CI): 0.798-0.919, sensitivity: 0.713, specificity: 0.875, < 0.001), indicating that they had a higher diagnostic value than individual LV strains. However, individual strains had no predictive value in identifying end-point events in HFpEF, the AUC of coanalysis of LV strains was 0.722 (95% CI: 0.573-0.872, sensitivity: 0.500, specificity: 0.959, = 0.004), indicating its prognostic relevance.
Individual strain analysis in CMR may be useful for diagnosing HFpEF, the combination of LV strain analysis had the highest diagnostic value. Moreover, the prognostic value of individual strain analysis in predicting HFpEF outcome was not satisfactory while the combined usage of LV strain analysis was prognostically valuable in HFpEF outcome prediction.
心脏磁共振（CMR）的应变分析对于射血分数保留的心力衰竭（HFpEF）的诊断和预后至关重要。我们的研究旨在确定 CMR 显示的应变分析在 HFpEF 中的诊断和预后价值。
根据指南招募 HFpEF 和对照组的参与者。收集基线信息、临床参数、血液样本，并进行超声心动图和 CMR 检查。从 CMR 测量左心室（LV）、右心室（RV）和左心房的整体纵向应变、整体圆周应变（GCS）和整体径向应变等各种参数。建立接受者操作特征曲线（ROC）以评估应变在 HFpEF 中的诊断和预后价值。
除了 RVGCS 之外，经过 t 检验后使用了七种应变来生成 ROC 曲线。所有应变对 HFpEF 均具有显著的诊断价值。LV 应变的曲线下面积（AUC）大于 0.7，LV 应变联合分析的 AUC 为 0.858（95%置信区间（CI）：0.798-0.919，灵敏度：0.713，特异性：0.875， < 0.001），表明其诊断价值高于单个 LV 应变。然而，单个应变在识别 HFpEF 的终点事件方面没有预测价值，LV 应变联合分析的 AUC 为 0.722（95%CI：0.573-0.872，灵敏度：0.500，特异性：0.959， = 0.004），表明其具有预后相关性。
CMR 中的个体应变分析可能有助于诊断 HFpEF，LV 应变分析的联合具有最高的诊断价值。此外，个体应变分析预测 HFpEF 结局的预后价值并不令人满意，而 LV 应变分析的联合使用在 HFpEF 结局预测中具有预后价值。
