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心血管磁共振衍生的 E、a、e'评估舒张功能:与超声心动图的比较。

Diastolic dysfunction evaluation by cardiovascular magnetic resonance derived E, a, e': Comparison to echocardiography.

机构信息

Department of Radiology and Biomedical Imaging, Yale University, New Haven, Connecticut, USA.

PARCC, INSERM, Université Paris Cité | Hôpital Européen Georges Pompidou, APHP, Paris, France.

出版信息

Physiol Rep. 2024 Dec;12(23):e70078. doi: 10.14814/phy2.70078.

Abstract

Transthoracic echocardiography (TTE) is the first-line and most useful imaging modality for evaluating diastolic dysfunction (DD). Cardiovascular magnetic resonance (CMR) has not been fully evaluated for this task. We investigated the utility of CMR for DD evaluation.Thirty-one patients with a recent TTE (within 4 months) were prospectively enrolled, along with 12 healthy age-matched subjects. CMR imaging was performed at 1.5 T to assess diastolic function by quantifying mitral inflow velocities (E and A), mitral annular velocities (e'), and left atrial volume (LAVi). Measurements by TTE and CMR were compared using regression. The diagnostic accuracy of CMR for DD was determined.CMR derived E, A, E/A, e' and E/e' all correlated moderately to strongly with TTE, and more strongly when comparing studies performed closer in time (E: r = 0.68, E deceleration time: r = 0.82, A: r = 0.78, e' r = 0.75, E/e': r = 0.80, p = 0.001; LAVi: r = 0.79, p < 0.001; E/A: r = 0.82, p < 0.001, n = 14 within 45 days). Using CMR criteria analogous to TTE, there was 82% (23/28) agreement regarding the presence of DD (95% CI [63 to 93%]), with 100% sensitivity and 75% specificity, and 71% (20/28) agreement in the absolute DD grade.CMR can evaluate diastolic function, with overall strong agreement to TTE.

摘要

经胸超声心动图(TTE)是评估舒张功能障碍(DD)的一线和最有用的成像方式。心血管磁共振(CMR)尚未对此任务进行充分评估。我们研究了 CMR 在 DD 评估中的效用。

前瞻性纳入 31 例近期 TTE(<4 个月)患者和 12 例年龄匹配的健康对照者。在 1.5T 上进行 CMR 成像,通过量化二尖瓣流入速度(E 和 A)、二尖瓣环速度(e')和左心房容积(LAVi)来评估舒张功能。使用回归比较 TTE 和 CMR 的测量值。确定 CMR 对 DD 的诊断准确性。

CMR 衍生的 E、A、E/A、e'和 E/e'与 TTE 均中度至高度相关,且在时间更接近时相关性更强(E:r=0.68,E 减速时间:r=0.82,A:r=0.78,e' r=0.75,E/e':r=0.80,p=0.001;LAVi:r=0.79,p<0.001;E/A:r=0.82,p<0.001,n=14 在 45 天内)。使用类似于 TTE 的 CMR 标准,有 82%(23/28)的 DD 存在情况(95%CI[63%~93%])具有一致性,敏感性为 100%,特异性为 75%,绝对 DD 分级的一致性为 71%(20/28)。

CMR 可以评估舒张功能,与 TTE 具有总体强一致性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4e0/11602526/0bdbed597629/PHY2-12-e70078-g006.jpg

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