Wong Hau Wai, Wang Haonan, Kwan Chi Ting, Wong Eponine Kate, Xu Yueyi, Leung Kwan Ho, Biekan Jumatay, Jang Jinyoung, Yiu Kai-Hang, Tse Hung-Fat, Janich Martin A, Montero David, Yan Andrew T, Ferreira Vanessa M, Ng Ming-Yen
Department of Diagnostic Radiology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China.
GE Healthcare, MR Clinical Solutions and Research Collaborations, Waukesha, Wisconsin, USA.
Eur Heart J Imaging Methods Pract. 2025 May 14;3(1):qyaf059. doi: 10.1093/ehjimp/qyaf059. eCollection 2025 Jan.
Cardiovascular magnetic resonance (CMR) 4-dimensional (4D) intraventricular flow analysis quantifies volume and kinetic energy (KE) of direct flow (DF), and residual volume (ReV) components, illustrating heart failure (HF) haemodynamic changes. Study aims were (1) compare volume and KE indexed (KEi) of DF and ReV between groups. (2) Assess relationship between 4D-flow parameters with CMR parameters.
187 subjects (63.0 ± 17.1 years; 101 males) comprising 78 controls, 47 HF with preserved ejection fraction (HFpEF), 25 HF with mildly reduced ejection fraction (HFmrEF), 37 HF with reduced ejection fraction (HFrEF) were included. Volume and KEi of DF, and ReV were obtained from 4D flow CMR images. Controls had highest DF volume and systolic KEi (control 35.0% and 54.7 µJ/mL), followed by HFpEF (22.7% and 61.4 µJ/mL), HFmrEF (13.1% and 43.3 µJ/mL), HFrEF (5.2% and 33.1 µJ/mL) ( < 0.001). ReV and diastolic KEi were lowest in controls (26.0% and 7.9 µJ/mL), and higher across HFpEF (31.8% and 7.8 µJ/mL), HFmrEF (41.6% and 10.8 µJ/mL), HFrEF (49.5% and 11.5 µJ/mL) ( < 0.001). DF volume correlated positively with left ventricular ejection fraction (LVEF) ( 0.794), but negatively with LV-end-diastolic volume indexed (EDVi) ( = -0.563) (all < 0.001). ReV correlated negatively with LVEF ( -0.737) but positively with LV-EDVi ( = 0.602) (all < 0.001). Loss of two diastolic peaks in KE time curves for HF patients were shown.
CMR 4D DF and ReV with their KEi showed haemodynamic changes and KEi time curve pattern distortions in HF.
心血管磁共振（CMR）的四维（4D）心室内血流分析可量化直流（DF）的容积和动能（KE）以及残余容积（ReV）成分，阐明心力衰竭（HF）的血流动力学变化。研究目的为：（1）比较各组间DF和ReV的容积及索引动能（KEi）。（2）评估4D血流参数与CMR参数之间的关系。
纳入187名受试者（63.0±17.1岁；101名男性），包括78名对照组、47名射血分数保留的心力衰竭（HFpEF）患者、25名射血分数轻度降低的心力衰竭（HFmrEF）患者、37名射血分数降低的心力衰竭（HFrEF）患者。DF的容积和KEi以及ReV由4D血流CMR图像获得。对照组的DF容积和收缩期KEi最高（对照组为35.0%和54.7µJ/mL），其次是HFpEF（22.7%和61.4µJ/mL）、HFmrEF（13.1%和43.3µJ/mL）、HFrEF（5.2%和33.1µJ/mL）（<0.001）。对照组的ReV和舒张期KEi最低（26.0%和7.9µJ/mL），HFpEF（31.8%和7.8µJ/mL）、HFmrEF（41.6%和10.8µJ/mL）、HFrEF（49.5%和11.5µJ/mL）中则更高（<0.001）。DF容积与左心室射血分数（LVEF）呈正相关（r=0.794），但与左心室舒张末期容积指数（EDVi）呈负相关（r=-0.563）（均<0.001）。ReV与LVEF呈负相关（r=-0.737），但与LV-EDVi呈正相关（r=0.602）（均<0.001）。显示了HF患者KE时间曲线中两个舒张期峰值的缺失。
CMR的4D DF和ReV及其KEi显示了HF中的血流动力学变化和KEi时间曲线模式畸变。
