Cau R, Bassareo P P, Porcu M, Mannelli L, Cherchi V, Suri J S, Saba L
Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554 Monserrato (Cagliari) 09045, Italy.
Mater Misericordiae University Hospital and Our Lady's Children's Hospital, University College of Dublin, Crumlin, Dublin, Republic of Ireland, USA.
Clin Radiol. 2023 Nov;78(11):e823-e830. doi: 10.1016/j.crad.2023.06.013. Epub 2023 Jul 31.
To evaluate the pulmonary transit time (PTT) and its derived parameters using cardiac magnetic resonance imaging (CMRI) as markers of diastolic dysfunction in Takotsubo syndrome (TS) and its relationship with transthoracic echocardiography and CMRI parameters.
Twenty-two patients with TS, who exhibited diastolic dysfunction as assessed by transthoracic echocardiography, were enrolled retrospectively and the PTT, pulmonary transit time index (PTTI), and pulmonary blood volume index (PBVI) were evaluated using first-pass CMRI. PTT was calculated as the number of cardiac cycles required for a bolus of contrast agent to move from the right ventricle (RV) to the left ventricle (LV), whereas PTTI represents the PTT interval corrected for the heart rate. Finally, PBVI was calculated as the product of PTTI, and RV stroke volume indexed for body surface area. Normal references of PTT, PTTI, and PBVI were evaluated in a cohort of 20 age- and sex-matched healthy controls.
Compared with healthy subjects, TS patients showed significantly higher PTT, PTTI, and PBVI (p=0.0001, p=0.0001, and p=0.002, respectively). Using multivariable logistic regression, PBVI provided the best differentiation between TS and controls (AUC 0.84). PBVI was significantly associated with the index of diastolic dysfunction and left atrial strain parameters. In addition, PBVI demonstrated a significant correlation with global T2 mapping (r=0,520, p=0,019).
PTT and the derived parameters, as assessed using first-pass CMRI, are potential tools for assessing LV diastolic dysfunction in patients with TS.
利用心脏磁共振成像（CMRI）评估肺循环时间（PTT）及其衍生参数，作为应激性心肌病（TS）舒张功能障碍的标志物，并探讨其与经胸超声心动图及CMRI参数的关系。
回顾性纳入22例经胸超声心动图评估存在舒张功能障碍的TS患者，采用首过CMRI评估PTT、肺循环时间指数（PTTI）和肺血容量指数（PBVI）。PTT计算为造影剂团注从右心室（RV）移动到左心室（LV）所需的心动周期数，而PTTI表示经心率校正的PTT间期。最后，PBVI计算为PTTI与体表面积校正的RV每搏量的乘积。在20名年龄和性别匹配的健康对照队列中评估PTT、PTTI和PBVI的正常参考值。
与健康受试者相比，TS患者的PTT、PTTI和PBVI显著更高（分别为p = 0.0001、p = 0.0001和p = 0.002）。使用多变量逻辑回归分析，PBVI在TS患者和对照组之间提供了最佳区分（曲线下面积0.84）。PBVI与舒张功能障碍指数和左心房应变参数显著相关。此外，PBVI与整体T2图谱显示出显著相关性（r = 0.520，p = 0.019）。
采用首过CMRI评估的PTT及其衍生参数是评估TS患者左心室舒张功能障碍的潜在工具。
