Chen Lei, Zhang Zeqing, Du Xinjia, Liu Jiahua, Liu Zhongxiao, Chen Wensu, Che Wenliang
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai 200072, China.
Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou 221002, China.
Eur Heart J Imaging Methods Pract. 2024 Jun 10;2(1):qyae053. doi: 10.1093/ehjimp/qyae053. eCollection 2024 Jan.
Recent studies have shown that extracellular volume (ECV) can also be obtained without blood sampling by the linear relationship between haematocrit (HCT) and blood pool R1 (1/T1). However, whether this relationship holds for patients with myocardial infarction is still unclear. This study established and validated an ECV model without blood sampling in ST-segment elevation myocardial infarction (STEMI) patients.
A total of 398 STEMI patients who underwent cardiac magnetic resonance (CMR) examination with T1 mapping and venous HCT within 24 h were retrospectively analysed. All patients were randomly divided into a derivation group and a validation group. The mean CMR scan time was 3 days after primary percutaneous coronary intervention. In the derivation group, a synthetic HCT formula was obtained by the linear regression between HCT and blood pool R1 ( = 0.45, < 0.001). The formula was used in the validation group; the results showed high concordance and correlation between synthetic ECV and conventional ECV in integral (bias = -0.12; = 0.92, < 0.001), myocardial infarction site (bias = -0.23; = 0.93, < 0.001), and non-myocardial infarction sites (bias = -0.09; = 0.94, < 0.001).
In STEMI patients, synthetic ECV without blood sampling had good consistency and correlation with conventional ECV. This study might provide a convenient and accurate method to obtain the ECV from CMR to identify myocardial fibrosis.
最近的研究表明，通过血细胞比容（HCT）与血池R1（1/T1）之间的线性关系，也可以在不进行采血的情况下获得细胞外容积（ECV）。然而，这种关系在心肌梗死患者中是否成立仍不清楚。本研究建立并验证了一种用于ST段抬高型心肌梗死（STEMI）患者的无需采血的ECV模型。
回顾性分析了398例在24小时内接受心脏磁共振（CMR）检查及T1 mapping和静脉HCT检测的STEMI患者。所有患者随机分为推导组和验证组。平均CMR扫描时间为初次经皮冠状动脉介入治疗后3天。在推导组中，通过HCT与血池R1之间的线性回归得到合成HCT公式（ = 0.45， < 0.001）。该公式用于验证组；结果显示，合成ECV与传统ECV在整体（偏差 = -0.12； = 0.92， < 0.001）、心肌梗死部位（偏差 = -0.23； = 0.93， < 0.001）和非心肌梗死部位（偏差 = -0.09； = 0.94， < 0.001）具有高度一致性和相关性。
在STEMI患者中，无需采血的合成ECV与传统ECV具有良好的一致性和相关性。本研究可能为从CMR获取ECV以识别心肌纤维化提供一种方便且准确的方法。
