Gao Yufan, Li Boxin, Ma Yanhe, Liang Shuo, Yu Anhong, Zhang Hong, Guo Zhigang
Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin 300072, China; Department of Radiology, Chest Hospital, Tianjin University, Tianjin 300222, China.
Department of Radiology, Chest Hospital, Tianjin University, Tianjin 300222, China.
J Cardiovasc Magn Reson. 2024;26(2):101111. doi: 10.1016/j.jocmr.2024.101111. Epub 2024 Oct 20.
Strain analysis offers a valuable tool to assess myocardial mechanics, allowing for the detection of impairments in heart function. This study aims to evaluate the pattern of myocardial strain in patients with heart failure (HF).
In the present study, myocardial strain was measured by cardiac magnetic resonance imaging feature tracking in 35 control subjects without HF and 195 HF patients. The HF patients were further categorized as HF with preserved ejection fraction (HFpEF, n = 80), with mid-range ejection fraction (HFmrEF, n = 34), and with reduced ejection fraction (HFrEF, n = 81). Additionally, quantitative tissue evaluation parameters, including native T1 relaxation time and extracellular volume (ECV), were examined.
Compared to controls, patients in all HF groups (HFpEF, HFmrEF, and HFrEF) demonstrated impaired left ventricular (LV) strains and systolic and diastolic strain rates in all three directions (radial, circumferential, and longitudinal) (p < 0.05 for all). LV strains also showed significant correlations with LV ejection fraction and brain natriuretic peptide levels (p < 0.001 for all). Notably, septal contraction was significantly affected in HFpEF compared to controls. While LV torsion was slightly increased in HFpEF, it was decreased in HFrEF. Native T1 relaxation times and ECV fractions were significantly higher in HFrEF compared to HFpEF (p < 0.05). Overall, myocardial strain parameters demonstrated good performance in differentiating HF categories.
The myocardial strain impairments exhibit a spectrum of severity in patients with HFpEF, HFmrEF, and HFrEF compared to controls. Assessment of myocardial mechanics using strain analysis may offer a clinically useful tool for monitoring the progression of systolic and diastolic dysfunction in HF patients.
应变分析为评估心肌力学提供了一种有价值的工具，可用于检测心脏功能障碍。本研究旨在评估心力衰竭（HF）患者的心肌应变模式。
在本研究中，通过心脏磁共振成像特征追踪技术，对35名无HF的对照受试者和195名HF患者进行心肌应变测量。HF患者进一步分为射血分数保留的HF（HFpEF，n = 80）、射血分数中等的HF（HFmrEF，n = 34）和射血分数降低的HF（HFrEF，n = 81）。此外，还检查了定量组织评估参数，包括固有T1弛豫时间和细胞外容积（ECV）。
与对照组相比，所有HF组（HFpEF、HFmrEF和HFrEF）的患者在三个方向（径向、圆周和纵向）均表现出左心室（LV）应变以及收缩期和舒张期应变率受损（所有p < 0.05）。LV应变也与LV射血分数和脑钠肽水平显著相关（所有p < 0.001）。值得注意的是，与对照组相比，HFpEF患者的室间隔收缩受到显著影响。虽然HFpEF患者的LV扭转略有增加，但HFrEF患者的LV扭转则降低。与HFpEF相比，HFrEF患者的固有T1弛豫时间和ECV分数显著更高（p < 0.05）。总体而言，心肌应变参数在区分HF类别方面表现良好。
与对照组相比，HFpEF、HFmrEF和HFrEF患者的心肌应变损伤表现出不同程度的严重程度。使用应变分析评估心肌力学可能为监测HF患者收缩期和舒张期功能障碍的进展提供一种临床有用的工具。
