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肥厚型心肌病患者左心房力学与左心室形态的关联:一项心脏磁共振研究。

The association of left atrial mechanics with left ventricular morphology in patients with hypertrophic cardiomyopathy: a cardiac magnetic resonance study.

作者信息

Guler Arda, Topel Cagdas, Sahin Ahmet Anil, Aydin Sinem, Guler Ekrem, Sancar Kadriye Memic, Cansever Aysel Turkvatan, Guler Gamze Babur, Erturk Mehmet

机构信息

Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

Department of Radiology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.

出版信息

Pol J Radiol. 2023 Feb 16;88:e103-e112. doi: 10.5114/pjr.2023.125213. eCollection 2023.

Abstract

PURPOSE

Hypertrophic cardiomyopathy (HCM) is related with structural and pathologic changes in the left atrium (LA) and left ventricle (LV). The aim of this study was to explore the association between LA mechanics and LV characteristics in patients with HCM using cardiac magnetic resonance feature tracking (CMR-FT).

MATERIAL AND METHODS

A total of 76 patients with HCM and 26 healthy controls were included in the study. The parameters including the extent of LV late gadolinium enhancement (LGE-%) and the LV early diastolic longitudinal strain rate (edLSR) were assessed for LV. LA conduit, booster, and reservoir functions were assessed by LA fractional volumes and strain analyses using CMR-FT. HCM patients were classified as HCM patients without LGE, with mild LGE-% (0% < LGE-% ł 10%), and prominent LGE-% (10% < LGE-%).

RESULTS

HCM patients had worse LA functions compared with the controls ( < 0.05). The majority of LA functional indices were more impaired in HCM patients with regard to LGE. LA volumes were higher in HCM patients with prominent LGE-% compared with HCM patients with mild LGE-% ( < 0.05). However, only a minority of LA functional parameters differed between the 2 groups. LA strain parameters showed weak to modest correlations with LV LGE-% and LV edLSR.

CONCLUSIONS

LV characteristics, to some extent, influence LA mechanics, but they might not be the only factor inducing LA dysfunction in patients with HCM.

摘要

目的

肥厚型心肌病(HCM)与左心房(LA)和左心室(LV)的结构及病理改变有关。本研究旨在利用心脏磁共振特征追踪(CMR-FT)探讨HCM患者LA力学与LV特征之间的关联。

材料与方法

本研究共纳入76例HCM患者和26例健康对照者。评估LV的参数包括LV晚期钆增强程度(LGE-%)和LV舒张早期纵向应变率(edLSR)。使用CMR-FT通过LA分数容积和应变分析评估LA的管道、助推器和储存功能。HCM患者被分为无LGE的HCM患者、轻度LGE-%(0% < LGE-% ≤ 10%)的HCM患者和显著LGE-%(10% < LGE-%)的HCM患者。

结果

与对照组相比,HCM患者的LA功能更差(P < 0.05)。就LGE而言,大多数LA功能指标在HCM患者中受损更严重。显著LGE-%的HCM患者的LA容积高于轻度LGE-%的HCM患者(P < 0.05)。然而,两组之间只有少数LA功能参数存在差异。LA应变参数与LV LGE-%和LV edLSR呈弱至中度相关。

结论

LV特征在一定程度上影响LA力学,但它们可能不是导致HCM患者LA功能障碍的唯一因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5434/9995245/18dc2304fa54/PJR-88-50167-g001.jpg

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