新冠康复患者的心脏磁共振弛豫测量参数、延迟钆增强及特征追踪心肌纵向应变
Cardiac Magnetic Resonance Relaxometry Parameters, Late Gadolinium Enhancement, and Feature-Tracking Myocardial Longitudinal Strain in Patients Recovered from COVID-19.
作者信息
Fijalkowska Jadwiga, Glinska Anna, Fijalkowski Marcin, Sienkiewicz Katarzyna, Kulawiak-Galaska Dorota, Szurowska Edyta, Pienkowska Joanna, Dorniak Karolina
机构信息
Second Department of Radiology, Medical University of Gdansk, 80-210 Gdansk, Poland.
First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland.
出版信息
J Cardiovasc Dev Dis. 2023 Jun 29;10(7):278. doi: 10.3390/jcdd10070278.
COVID-19 infection is associated with myocarditis, and cardiovascular magnetic resonance (CMR) is the reference non-invasive imaging modality for myocardial tissue characterization. Quantitative CMR techniques, such as feature tracking (FT) and left ventricular global longitudinal strain (GLS) analysis, have been introduced as promising diagnostic tools to improve the diagnostic accuracy of suspected myocarditis. The aim of this study was to analyze the left ventricular global longitudinal strain (GLS) and the influence of T1 and T2 relaxation times, ECV, and LGE appearance on GLS parameters in a multiparametric imaging protocol in patients who recovered from COVID-19. The 86 consecutive patients enrolled in the study had all recovered from mild or moderate COVID-19 infections; none required hospitalization. Their persistent symptoms and suspected myocarditis led to cardiac magnetic resonance imaging within 3 months of the diagnosis of the SARS-CoV-2 infection. Results: Patients with GLS less negative than -15% had significantly lower LVEF (53.6% ± 8.9 vs. 61.6% ± 4.8; <0.001) and were significantly more likely to have prolonged T1 (28.6% vs. 7.5%; = 0.019). Left ventricular GLS correlated significantly with T1 (r = 0.303; = 0.006) and LVEF (r = -0.732; < 0.001). Left ventricular GLS less negative than -15% was 7.5 times more likely in patients with prolonged T1 (HR 7.62; 95% CI 1.25-46.64). The reduced basal inferolateral longitudinal strain had a significant impact on the global left ventricular longitudinal strain. ROC results suggested that a GLS of 14.5% predicted prolonged T1 relaxation time with the best sensitivity and specificity. Conclusions: CMR abnormalities, including a myocarditis pattern, are common in patients who have recovered from COVID-19. The CMR feature-tracking left ventricular GLS is related to T1 relaxation time and may serve as a novel parameter to detect global and regional myocardial injury and dysfunction in patients with suspected myocardial involvement after recovery from COVID-19.
新型冠状病毒肺炎(COVID-19)感染与心肌炎相关,而心血管磁共振成像(CMR)是用于心肌组织特征描述的参考性无创成像方式。定量CMR技术,如特征追踪(FT)和左心室整体纵向应变(GLS)分析,已作为有前景的诊断工具被引入,以提高疑似心肌炎的诊断准确性。本研究的目的是在从COVID-19中康复的患者的多参数成像方案中,分析左心室整体纵向应变(GLS)以及T1和T2弛豫时间、细胞外容积(ECV)和延迟钆增强(LGE)表现对GLS参数的影响。连续纳入本研究的86例患者均从轻度或中度COVID-19感染中康复;均无需住院治疗。他们持续存在的症状及疑似心肌炎导致在严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染诊断后的3个月内进行了心脏磁共振成像检查。结果:GLS负值小于-15%的患者左心室射血分数(LVEF)显著更低(53.6%±8.9 vs. 61.6%±4.8;<0.001),且T1延长的可能性显著更高(28.6% vs. 7.5%;P = 0.019)。左心室GLS与T1(r = 0.303;P = 0.006)和LVEF(r = -0.732;P < 0.001)显著相关。T1延长的患者中,GLS负值小于-15%的可能性高7.5倍(风险比7.62;95%置信区间1.25 - 46.64)。基底段下外侧纵向应变降低对左心室整体纵向应变有显著影响。ROC结果表明,GLS为14.5%时预测T1弛豫时间延长具有最佳的敏感性和特异性。结论:CMR异常,包括心肌炎模式,在从COVID-19中康复的患者中很常见。CMR特征追踪左心室GLS与T1弛豫时间相关,可作为检测从COVID-19康复后疑似心肌受累患者的整体和局部心肌损伤及功能障碍的新参数。
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