Li Qing, Gao Xuelian, Zhou Zhen, Zhang Hongkai, Li Wenjie, Gao Yifeng, Bo Kairui, Wang Hui, Wang Rui, Sun Zhonghua, Xu Lei
Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
Quant Imaging Med Surg. 2023 Jul 1;13(7):4103-4116. doi: 10.21037/qims-22-1119. Epub 2023 Apr 20.
Cardiac power (CP; CP = 0.222 × cardiac output × mean blood pressure) output in patients with heart failure has been studied previously, but its importance in patients with hypertrophic cardiomyopathy (HCM) remains unclear. The present study aimed to explore the role of normalized CP (normalized CP = CP/ventricle mass) in assessing cardiac function in patients with HCM with normal ejection fraction using cardiac magnetic resonance (CMR).
This cross-sectional study enrolled 99 patients with HCM who underwent CMR from December 2020 to January 2022 at Beijing Anzhen Hospital, and these patients were classified into heart failure or non-heart failure subgroups. Meanwhile, a control group comprising 65 gender- and age-matched healthy volunteers was also enrolled. The baseline clinical characteristics and cardiac functional parameters were compared between the patients with HCM and the controls, and multivariable linear regression analysis was performed to analyze the relationship between normalized CP and the relevant factors.
Significantly higher CP (1.19 . 1.01 W; P=0.03) but lower normalized CP (0.73 . 1.12 W/100 g; P<0.001) were found in patients with HCM as compared with the controls. Multivariable analysis showed that HCM correlated well with normalized CP [β=-0.235; 95% confidence interval (CI): -0.341 to -0.129; P<0.001]. In the HCM group, there were 34 cases with heart failure and 65 with non-heart failure, and the patients with HCM with heart failure showed similar CP (1.14 . 1.24 W; P=0.06) but significantly lower normalized CP (0.54 . 0.78 W/100 g; P<0.001). The correlation analysis of normalized CP and functional parameters revealed that normalized CP was inversely correlated with left ventricle mass/body surface area (R=-0.509; 95% CI: -0.646 to -0.341; P<0.001) in patients with HCM.
Normalized CP decreased significantly and was negatively correlated with ventricle mass, indicating impaired cardiac pump function in patients with HCM. Normalized CP might play a critical role in detecting and evaluating impaired cardiac pump function in patients with HCM with preserved ejection fraction.
心力衰竭患者的心脏功率（CP；CP = 0.222×心输出量×平均血压）输出此前已有研究，但在肥厚型心肌病（HCM）患者中的重要性仍不明确。本研究旨在利用心脏磁共振成像（CMR）探讨标准化CP（标准化CP = CP/心室质量）在评估射血分数正常的HCM患者心功能中的作用。
本横断面研究纳入了99例于2020年12月至2022年1月在北京安贞医院接受CMR检查的HCM患者，并将这些患者分为心力衰竭或非心力衰竭亚组。同时，还纳入了一个由65名性别和年龄匹配的健康志愿者组成的对照组。比较HCM患者与对照组的基线临床特征和心功能参数，并进行多变量线性回归分析以分析标准化CP与相关因素之间的关系。
与对照组相比，HCM患者的CP显著更高（1.19. 1.01 W；P = 0.03），但标准化CP更低（0.73. 1.12 W/100 g；P < 0.001）。多变量分析显示，HCM与标准化CP密切相关[β = -0.235；95%置信区间（CI）：-0.341至-0.129；P < 0.001]。在HCM组中，有34例心力衰竭患者和65例非心力衰竭患者，HCM合并心力衰竭患者的CP相似（1.14. 1.24 W；P = 0.06），但标准化CP显著更低（0.54. 0.78 W/100 g；P < 0.001）。标准化CP与功能参数的相关性分析显示，在HCM患者中，标准化CP与左心室质量/体表面积呈负相关（R = -0.509；95% CI：-0.646至-0.341；P < 0.001）。
标准化CP显著降低且与心室质量呈负相关，表明HCM患者存在心脏泵功能受损。标准化CP可能在检测和评估射血分数保留的HCM患者心脏泵功能受损方面发挥关键作用。
