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心脏磁共振斑点追踪技术评价房间隔缺损相关肺动脉高压患者右心室心肌应变

Evaluation of right ventricular myocardial strain in pulmonary arterial hypertension associated with atrial septal defect by cardiac magnetic resonance feature tracking.

机构信息

Department of Cardiology, Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Quanshan District, Xuzhou, 221000, Jiangsu Province, China.

Intensive Care Unit, Traditional Chinese Medicine Hospital of Kunshan, Suzhou, Jiangsu Province, China.

出版信息

Int J Cardiovasc Imaging. 2022 Sep;38(9):2035-2045. doi: 10.1007/s10554-022-02591-2. Epub 2022 May 9.

Abstract

We aimed to research the role of right ventricular strain parameters (RVSP) quantified by cardiac magnetic resonance feature tracking (CMR-FT) in the early assessment of right ventricular (RV) function in patients with pulmonary arterial hypertension associated with atrial septal defect (PAH-ASD). From September 2017 to May 2021, we retrospectively enrolled 41 patients with PAH-ASD and 20 healthy controls. All subjects underwent CMR-FT, and right heart catheterization was conducted in patients with PAH-ASD. The relationship between RVSP and RV functional parameters was subjected to correlation analysis, and intragroup correlation coefficient (ICC) and Bland-Altman plots were used to assess the consistency. The subjects were divided into three groups: Group A (controls; n = 20), Group B (PAH-ASD, RVEF ≥ 45%; n = 14), and Group C (PAH-ASD, RVEF < 45%; n = 27). Compared with healthy controls, the RV global longitudinal strain (GLS) in Group B was significantly decreased (- 19.68 ± 2.72% vs. - 25.21 ± 3.6%, P < 0.05). In RVEF-preserved PAH-ASD patients (Group B), compared with patients with GLS ≤ - 20%, patients with GLS > - 20% also had significantly elevated right ventricular end-diastolic pressure (RVEDP) [8 (6.5-8.25) mmHg vs. 4.5 ± 1.64 mmHg, P < 0.05]. RV GLS had a moderate to strong correlation with RVEF, RVESVi, RVEDVi, RVEDP, and NT-proBNP (P < 0.05). ICC and Bland-Altman plots showed good intragroup and intergroup consistency in radial, circumferential and longitudinal strains of RV. In conclusion, it is feasible to quantify RV strain in patients with PAH-ASD by CMR-FT, and GLS is valuable for the early assessment of RV dysfunction in patients with PAH-ASD.

摘要

我们旨在研究心脏磁共振特征追踪(CMR-FT)量化的右心室应变参数(RVSP)在伴有房间隔缺损(PAH-ASD)的肺动脉高压患者早期评估右心室(RV)功能中的作用。2017 年 9 月至 2021 年 5 月,我们回顾性纳入 41 例 PAH-ASD 患者和 20 例健康对照者。所有患者均接受 CMR-FT 检查,PAH-ASD 患者接受右心导管检查。分析 RVSP 与 RV 功能参数的相关性,并采用组内相关系数(ICC)和 Bland-Altman 图评估一致性。将患者分为三组:A 组(对照组;n=20)、B 组(PAH-ASD,RVEF≥45%;n=14)和 C 组(PAH-ASD,RVEF<45%;n=27)。与健康对照组相比,B 组 RV 整体纵向应变(GLS)明显降低(-19.68±2.72%比-25.21±3.6%,P<0.05)。在保留射血分数的 PAH-ASD 患者(B 组)中,与 GLS≤-20%的患者相比,GLS>-20%的患者右心室舒张末期压(RVEDP)也显著升高[8(6.5-8.25)mmHg 比 4.5±1.64mmHg,P<0.05]。RV GLS 与 RVEF、RVESVi、RVEDVi、RVEDP 和 NT-proBNP 具有中到高度相关性(P<0.05)。ICC 和 Bland-Altman 图显示 RV 径向、环向和纵向应变的组内和组间一致性良好。总之,CMR-FT 可用于量化 PAH-ASD 患者的 RV 应变,GLS 对评估 PAH-ASD 患者 RV 功能障碍具有重要价值。

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