心脏磁共振电影成像在射血分数保留心力衰竭诊治中的应用  

Application of cardiac magnetic resonance cine imaging in diagnosis and treatment of heart failure with preserved ejection fraction

作　　者：陶逸菁 高程洁 吴昊[1] 万青[1] 夏智丽 潘静薇[1] 魏盟[1] TAO Yi-jing;GAO Cheng-jie;WU Hao;WAN Qing;XIA Zhi-li;PAN Jing-wei;WEI Meng(Department of Cardiology, Shanghai Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai 200233, China)

机构地区：[1]上海交通大学附属上海市第六人民医院心内科,上海200233

出　　处：《第二军医大学学报》2017年第10期1273-1278,共6页Academic Journal of Second Military Medical University

基　　金：上海市卫生和计划生育委员会项目(20134015);上海市第六人民医院预研基金(LYZY-0109)~~

摘　　要：目的探讨心脏磁共振电影成像在评价射血分数保留心力衰竭(HFpEF)左心室舒张功能中的作用。方法应用心脏磁共振成像获取30例HFpEF患者和15例心功能正常者(对照组)的左心室长轴两腔、三腔、四腔及系列短轴电影图像,绘制左心室容积-时间曲线(VTC)及整体应变曲线,比较两组峰值充盈速率及充盈量,以及整体纵向、径向、周向峰值应变和应变率等参数。结果与对照组相比,HFpEF患者左心室重构指数(LVRI)增加(0.86±0.15vs 0.73±0.08,P<0.05),舒张早、晚期峰值充盈速率比(PFR1/PFR2)降低或倒置(0.74±0.14vs 1.43±0.34,P=0.001),早期充盈量(FV1)及其占总充盈量比例降低(26.24±9.74vs 31.30±5.17,0.59±0.05vs 0.69±0.03;P均<0.05),左心室整体纵向峰值应变(GLS)降低[(-14.96±1.79)%vs(-20.96±0.84)%,P<0.01],整体纵向、径向、周向峰值应变率均降低(0.65±0.16vs 1.29±0.27,-2.23±0.71vs-3.80±1.13,1.02±0.14vs 1.77±0.63;P均<0.05)。结论通过心脏磁共振获得的LVRI、PFR1/PFR2、FV1和整体周向峰值应变率能够较准确地反映HFpEF左心室舒张功能的改变,对于HFpEF诊治具有较高的临床价值。ObjectiveTo explore the role of cine sequence of cardiac magnetic resonance(CMR)imaging in evaluating left ventricular(LV)diastolic function in patients with heart failure with preserved ejection fraction(HFpEF).MethodsLV two chamber,three chamber,four chamber long axis and series of short axis cine images were obtained from30patients with HFpEF(HFpEF group)and15cases with normal cardiac function(control group)using CMR examination.LV volume time curve(VTC)and global strain curves were drawn.Peak filling rate and peak filling volume,global longitudinal,global radial,global circumferential peak strain and peak diastolic strain rate were compared between the two groups.ResultsCompared with the control group,LV remodeling index(LVRI)in the HFpEF group was significantly increased(0.86±0.15vs0.73±0.08,P<0.05),first peak filling rate/second peak filling rate(PFR1/PFR2)was significantly decreased or even inverted(0.74±0.14vs1.43±0.34,P=0.001),and first filling volume(FV1)and FV1/total filling volume(FV1/FV)were significantly decreased(26.24±9.74vs31.30±5.17,P<0.05;0.59±0.05vs0.69±0.03,P<0.05).Global longitudinal peak strain(GLS)([-14.96±1.79]%vs[-20.96±0.84]%,P<0.01),global longitudinal diastolic peak strain rate(0.65±0.16vs1.29±0.27,P<0.05),global radial diastolic peak strain rate(-2.23±0.71vs-3.80±1.13,P<0.05)and global circumferential diastolic peak strain rate(GDCSR)(1.02±0.14vs1.77±0.63,P<0.05)in the HFpEF group were significantly decreased versus control group.ConclusionLVRI,PFR1/PFR2,FV1and GDCSR obtained by CMR can accurately evaluate the changes of LV diastolic function in HFpEF,which may play important roles in the diagnosis and treatment of HFpEF.

关 键 词：电影磁共振成像 射血分数保留心力衰竭 容积时间曲线 应变 

分 类 号：R541.61[医药卫生—心血管疾病] R445.2[医药卫生—内科学]