CMR-特征追踪技术检测的心肌应变与非缺血性心肌病患者电解剖标测检测到的基质异常的相关性。
Correlation of myocardial strain by CMR-feature tracking with substrate abnormalities detected by electro-anatomical mapping in patients with nonischemic cardiomyopathy.
机构信息
ANU School of Medicine and Psychology, Australian National University, 54 Mills Road, Acton, 2601, ACT, Australia.
Canberra Health Services, 2 Garran place, Garran, Canberra, 2605, Australia.
出版信息
J Interv Card Electrophysiol. 2023 Dec;66(9):2113-2123. doi: 10.1007/s10840-023-01553-5. Epub 2023 May 2.
BACKGROUND
Late gadolinium enhancement (LGE) detected by cardiac MRI (CMR) has low correlation with low voltage zones (LVZs) detected by electroanatomical mapping (EAM). We aim to study correlation of myocardial strain by CMR- Feature Tracking (FT) alongside LGE with LVZs detected by EAM.
METHODS
Nineteen consecutive CMRs of patients with EAM were analyzed offline by CMR-FT. Peak value of circumferential strain (CS), longitudinal strain (LS), and LGE was measured in each segment of the left ventricle (17-segment model). The percentage of myocardial segments with CS and LS > -17% was determined. Percentage area of LGE-scar was calculated. Global and segment-wise bipolar and unipolar voltage was collected. Percentage area of bipolar LVZ (<1.5 mV) and unipolar LVZ (<8.3 mV) was calculated.
RESULTS
Mean age was 62±11 years. Mean LVEF was 37±13%. Mean global CS was -11.8±5%. Mean global LS was -11.2±4%. LGE-scar was noted in 74% of the patients. Mean percentage area of LGE-scar was 5%. There was significant correlation between percentage abnormality detected by LS with percentage bipolar LVZ (r = +0.5, p = 0.03) and combined percentage CS+LS abnormality with percentage unipolar LVZ (r = +0.5, p = 0.02). Per-unit increase in CS increased the percentage area of unipolar LVZ by 2.09 (p = 0.07) and per-unit increase in LS increased the percentage area of unipolar LVZ by 2.49 (p = 0.06). The concordance rates between CS and LS to localize segments with bipolar/unipolar LVZ were 79% and 95% compared to 63% with LGE.
CONCLUSIONS
Myocardial strain detected by CMR-FT has a better correlation with electrical low voltage zones than the conventional LGE.
背景
心脏磁共振（CMR）检测到的晚期钆增强（LGE）与电解剖图（EAM）检测到的低电压区（LVZ）相关性较低。我们旨在研究 CMR-特征追踪（FT）检测到的心肌应变与 EAM 检测到的 LVZ 的相关性。
方法
对 19 例连续进行 EAM 的 CMR 进行离线分析，通过 CMR-FT 进行分析。测量左心室（17 节段模型）各节段的圆周应变（CS）、纵向应变（LS）和 LGE 的峰值。确定 CS 和 LS ＞-17%的心肌节段百分比。计算 LGE 瘢痕的面积百分比。采集全局和节段双极和单极电压。计算双极 LVZ（＜1.5 mV）和单极 LVZ（＜8.3 mV）的面积百分比。
结果
平均年龄为 62±11 岁。平均 LVEF 为 37±13%。平均全局 CS 为-11.8±5%。平均全局 LS 为-11.2±4%。74%的患者有 LGE 瘢痕。平均 LGE 瘢痕面积百分比为 5%。LS 检测到的异常百分比与双极 LVZ 的百分比有显著相关性（r=+0.5，p=0.03），CS+LS 异常的总和与单极 LVZ 的百分比有显著相关性（r=+0.5，p=0.02）。CS 每增加一个单位，单极 LVZ 的面积百分比增加 2.09（p=0.07），LS 每增加一个单位，单极 LVZ 的面积百分比增加 2.49（p=0.06）。CS 和 LS 定位双极/单极 LVZ 节段的一致性率分别为 79%和 95%，而 LGE 为 63%。
结论
CMR-FT 检测到的心肌应变与电低电压区的相关性优于传统的 LGE。
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