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心肌梗死后保留射血分数的心肌炎患者右心室功能的心脏磁共振斑点追踪分析。

Cardiac Magnetic Resonance Speckle Tracking Analysis of Right Ventricle Function in Myocarditis with Preserved Right Ventricular Ejection Fraction.

机构信息

Department of Cardiology, Memorial Bahcelievler Hospital, Istanbul 34100, Turkey.

Department of Cardiology, Gazi University Faculty of Medicine, Ankara 06500, Turkey.

出版信息

Medicina (Kaunas). 2024 Sep 25;60(10):1569. doi: 10.3390/medicina60101569.

Abstract

: Diagnosis of myocarditis remains a challenge in clinical practice; however, magnetic resonance imaging (CMRI) can ease the diagnostic approach by providing various parameters. The prevalence of right ventricular involvement in acute myocarditis is suggested to be more frequent than previously hypothesized. In this study, we sought to investigate subclinical RV involvement in patients with acute myocarditis and preserved RV ejection fraction (EF), using CMRI RV speckle-tracking imaging. : CMRI of 27 patients with acute myocarditis (nine females, age 35.1 ± 12.2 y) was retrospectively analyzed. A control group consisting of CMRI images of 27 healthy individuals was included. : No significant differences were found regarding left ventricle (LV) and atrium dimensions. LV ejection fraction was significantly different between groups (56.6 ± 10.6 vs. 62.1 ± 2.6, < 0.05). No significant differences were present between parameters used for conventional assessment of RV. However, RV strain absolute values were significantly lower in the acute myocarditis group in comparison with that of the control group (18.4 ± 5.4 vs. 21.8 ± 2.8, = 0.018). : Subclinical RV dysfunction detected by CMR-derived strain may be present in patients with acute myocarditis even with preserved RVEF.

摘要

心肌炎的诊断在临床实践中仍然具有挑战性;然而,磁共振成像(CMRI)可以通过提供各种参数来简化诊断方法。急性心肌炎中右心室受累的患病率比以前假设的更为频繁。在这项研究中,我们试图使用 CMRI RV 斑点追踪成像来研究急性心肌炎和保留右心室射血分数(EF)患者的亚临床 RV 受累。

回顾性分析了 27 例急性心肌炎患者(9 名女性,年龄 35.1 ± 12.2 岁)的 CMRI。包括 27 例健康个体的 CMRI 图像的对照组。

左心室(LV)和心房尺寸无明显差异。LV 射血分数在两组间有显著差异(56.6 ± 10.6 与 62.1 ± 2.6, < 0.05)。常规评估 RV 所用参数之间无显著差异。然而,与对照组相比,急性心肌炎组的 RV 应变绝对值明显较低(18.4 ± 5.4 与 21.8 ± 2.8, = 0.018)。

通过 CMRI 应变检测到的亚临床 RV 功能障碍可能存在于急性心肌炎患者中,即使 RVEF 保留。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ef1/11509740/220b653d87c9/medicina-60-01569-g001.jpg

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