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慢性血栓栓塞性高血压患者球囊肺血管成形术前、后左右心室T1和T2血池成像的价值

Value of Right and Left Ventricular T1 and T2 Blood Pool Mapping in Patients with Chronic Thromboembolic Hypertension before and after Balloon Pulmonary Angioplasty.

作者信息

Roller Fritz C, Schüßler Armin, Kremer Nils, Harth Sebastian, Kriechbaum Steffen D, Wiedenroth Christoph B, Guth Stefan, Breithecker Andreas, Richter Manuel, Tello Khodr, Seeger Werner, Mayer Eckhard, Krombach Gabriele A

机构信息

Department of Diagnostic and Interventional Radiology, Justus-Liebig-University Giessen, Klinikstraße 33, 35392 Giessen, Germany.

German Center for Lung Research (DZL), 35392 Giessen, Germany.

出版信息

J Clin Med. 2023 Mar 7;12(6):2092. doi: 10.3390/jcm12062092.

Abstract

BACKGROUND

Parametric imaging has taken a steep rise in recent years and non-cardiac applications are of increasing interest. Therefore, the aim of our study was to assess right (RV) and left ventricular (LV) blood pool T1 and T2 values in patients with chronic thromboembolic pulmonary hypertension (CTEPH) compared to control subjects and their correlation to pulmonary hemodynamic.

METHODS

26 patients with CTEPH (mean age 64.8 years ± 12.8 SD; 15 female), who underwent CMR and right heart catheterization (RHC) before and 6-months after balloon pulmonary angioplasty (BPA), were retrospectively included. Ventricular blood pool values were measured, compared to control subjects (mean age 40.5 years ± 12.8 SD; 16 female) and correlated to invasive measures (CI, mPAP, PVR).

RESULTS

In both, control subjects and CTEPH patients, RVT1 and RVT2 were significantly reduced compared to LVT1 and LVT2. Compared to control subjects, RVT2 was significantly reduced in CTEPH patients ( = 0.0065) and increased significantly after BPA ( = 0.0048). Moreover, RVT2 was positively correlated with CI and negatively correlated with mPAP and PVR before (r = 0.5155, r = -0.2541, r = -0.4571) and after BPA (r = 0.4769, r = -0.2585, r = -0.4396).

CONCLUSION

Ventricular blood pool T2 mapping might be novel non-invasive CMR imaging marker for assessment of disease severity, prognosis, follow-up and even therapy monitoring in PH.

摘要

背景

近年来,参数成像迅速兴起,非心脏应用也越来越受到关注。因此,我们研究的目的是评估慢性血栓栓塞性肺动脉高压(CTEPH)患者与对照受试者相比右心室(RV)和左心室(LV)血池的T1和T2值,以及它们与肺血流动力学的相关性。

方法

回顾性纳入26例CTEPH患者(平均年龄64.8岁±12.8标准差;15例女性),这些患者在球囊肺动脉血管成形术(BPA)前和术后6个月接受了心脏磁共振成像(CMR)和右心导管检查(RHC)。测量心室血池值,并与对照受试者(平均年龄40.5岁±12.8标准差;16例女性)进行比较,并与侵入性测量值(心排血量、平均肺动脉压、肺血管阻力)相关联。

结果

在对照受试者和CTEPH患者中,与LVT1和LVT2相比,RVT1和RVT2均显著降低。与对照受试者相比,CTEPH患者的RVT2显著降低(P = 0.0065),BPA后显著升高(P = 0.0048)。此外,RVT2与BPA前(r = 0.5155,r = -0.2541,r = -0.4571)和BPA后(r = 0.4769,r = -0.2585,r = -0.4396)的心排血量呈正相关,与平均肺动脉压和肺血管阻力呈负相关。

结论

心室血池T2映射可能是一种用于评估肺动脉高压疾病严重程度、预后、随访甚至治疗监测的新型非侵入性CMR成像标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec7c/10052780/98bb44c95add/jcm-12-02092-g001.jpg

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