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射血分数保留的急性心肌炎患者心房和心室受累情况:一项单中心心血管磁共振研究

Atrial and Ventricular Involvement in Acute Myocarditis Patients with Preserved Ejection Fraction: A Single-Center Cardiovascular Magnetic Resonance Study.

作者信息

Cau Riccardo, Pisu Francesco, Muscogiuri Giuseppe, Suri Jasjit S, Montisci Roberta, Saba Luca

机构信息

Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari-Polo di Monserrato s.s. 554 Monserrato (Cagliari), 09045 Cagliari, Italy.

School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy.

出版信息

J Cardiovasc Dev Dis. 2024 Jun 25;11(7):191. doi: 10.3390/jcdd11070191.

Abstract

Cardiac magnetic resonance (CMR) is commonly employed to confirm the diagnosis of acute myocarditis (AM). However, the impact of atrial and ventricular function in AM patients with preserved ejection fraction (EF) deserves further investigation. Therefore, the aim of this study was to explore the incremental diagnostic value of combining atrial and strain functions using CMR in patients with AM and preserved EF. This retrospective study collected CMR scans of 126 consecutive patients with AM (meeting the Lake Louise criteria) and with preserved EF, as well as 52 age- and sex-matched control subjects. Left atrial (LA) and left ventricular (LV) strain functions were assessed using conventional cine-SSFP sequences. In patients with AM and preserved EF, impaired ventricular and atrial strain functions were observed compared to control subjects. These impairments remained significant even in multivariable analysis. The combined model of atrial and ventricular functions proved to be the most effective in distinguishing AM patients with preserved ejection fraction from control subjects, achieving an area under the curve of 0.77 and showing a significant improvement in the likelihood ratio. These findings suggest that a combined analysis of both atrial and ventricular functions may improve the diagnostic accuracy for patients with AM and preserved EF.

摘要

心脏磁共振成像(CMR)常用于确诊急性心肌炎(AM)。然而,射血分数(EF)保留的AM患者的心房和心室功能影响值得进一步研究。因此,本研究的目的是探讨在射血分数保留的AM患者中,使用CMR联合分析心房和应变功能的增量诊断价值。这项回顾性研究收集了126例连续的符合AM(符合路易斯湖标准)且射血分数保留的患者以及52例年龄和性别匹配的对照受试者的CMR扫描图像。使用传统的电影稳态自由进动(cine-SSFP)序列评估左心房(LA)和左心室(LV)的应变功能。与对照受试者相比,在射血分数保留的AM患者中观察到心室和心房应变功能受损。即使在多变量分析中,这些损害仍然显著。心房和心室功能的联合模型被证明在区分射血分数保留的AM患者与对照受试者方面最有效,曲线下面积为0.77,似然比有显著改善。这些发现表明,联合分析心房和心室功能可能提高射血分数保留的AM患者的诊断准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a6/11276940/da6064ea3260/jcdd-11-00191-g001.jpg

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