Bo Kairui, Zhao Yichen, Gao Xuelian, Chen Yanchun, Ren Yue, Gao Yifeng, Zhou Zhen, Wang Hui, Xu Lei
Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Heliyon. 2024 Mar 28;10(7):e28768. doi: 10.1016/j.heliyon.2024.e28768. eCollection 2024 Apr 15.
To explore the diagnostic value of cardiac magnetic resonance feature tracking (CMR-FT) divided left atrial (LA) strain in differentiating constrictive pericarditis (CP) and restrictive cardiomyopathy (RCM).
Patients with CP (n = 40) and RCM (n = 40), and another 40 normal control group were retrospectively enrolled over a period of 8 years at a tertiary cardiac centre. Left ventricular (LV) and biatrial strain and strain rate (SR) were measured. Atrial strain was used to differentiate between patients with CP and RCM. Then, patients were grouped according to their left ventricular ejection fraction (LVEF), either ≥50% or < 50%. A deeper analysis was done to evaluate the diagnostic value of atrial strain in these subgroups. Receiver operating characteristic curves (ROC) were used to assess the accuracy of myocardial strain based on CMR FT for the differential diagnosis of CP and RCM.
LV and LA strain and SR were significantly lower in patients with CP and RCM than those in the normal controls (P < 0.05). LA strain and SR were significantly lower in the RCM group than in the CP group (P < 0.05). In patients with either LVEF≥50% or＜50%, LA strain were lower in the RCM group than in the CP group (P < 0.05). ROC analysis showed that LA stored strain (LA-εs) had a good differential diagnostic value for CP and RCM, with an area under the curve (AUC) of 0.811 and an optimal cutoff value of 6.98%, above this value it tends to develop CP. Further, an excellent differential diagnostic value was found in patients with LVEF＜50%, with an AUC of 0.955.
LA strain analysis obtained by CMR-FT provides good differential diagnostic value for distinguishing CP from RCM, especially in patients with LVEF＜50%.
探讨心脏磁共振特征追踪（CMR-FT）测量的左心房（LA）应变在鉴别缩窄性心包炎（CP）和限制型心肌病（RCM）中的诊断价值。
在一家三级心脏中心，回顾性纳入了8年间收治的CP患者（n = 40）、RCM患者（n = 40）以及另外40名正常对照组。测量左心室（LV）和双心房应变及应变率（SR）。利用心房应变来鉴别CP和RCM患者。然后，根据左心室射血分数（LVEF）将患者分为≥50%或<50%两组。对这些亚组进行更深入分析，以评估心房应变的诊断价值。采用受试者工作特征曲线（ROC）评估基于CMR-FT的心肌应变对CP和RCM鉴别诊断的准确性。
CP和RCM患者的LV和LA应变及SR显著低于正常对照组（P < 0.05）。RCM组的LA应变及SR显著低于CP组（P < 0.05）。在LVEF≥50%或<50%的患者中，RCM组的LA应变均低于CP组（P < 0.05）。ROC分析显示，LA储存应变（LA-εs）对CP和RCM具有良好的鉴别诊断价值，曲线下面积（AUC）为0.811，最佳截断值为6.98%，高于此值倾向于诊断为CP。此外，在LVEF<50%的患者中发现了极好的鉴别诊断价值，AUC为0.955。
CMR-FT获得的LA应变分析对区分CP和RCM具有良好的鉴别诊断价值，尤其是在LVEF<50%的患者中。
