基于心脏磁共振特征追踪成像的舒张期峰值应变率在射血分数保留的肥厚型心肌病中的应用价值及其与心脏肌钙蛋白T的关系  

Assessment value of peak diastolic strain rate based on CMR-FT imaging in hypertrophic cardiomyopathy with preserved ejection fraction and its relationship with cardiac troponin T

作　　者：张莉莎 杨瑞雪 王磊[2] 郜发宝[1,2] ZHANG Lisha;YANG Ruixue;WANG Lei;GAO Fabao(Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China;Molecular Imaging Center,West China Hospital,Sichuan University,Chengdu 610044,China)

机构地区：[1]四川大学华西医院放射科,成都610041 [2]四川大学华西医院分子影像中心,成都610044

出　　处：《磁共振成像》2022年第12期45-50,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:81930046、81829003)。

摘　　要：目的探讨舒张期峰值应变率(peak diastolic strain rate,PDSR)在射血分数保留的肥厚型心肌病(hypertrophic cardiomyopathy with preserved ejection fraction,HCMpEF)中的应用价值及其与心肌肌钙蛋白T(cardiac troponin T,cTnT)的关系。材料与方法回顾性分析经3.0 T增强心脏磁共振(cardiac magnetic resonance,CMR)检查(HCMpEF患者还同时进行了cTnT的检测)的64例HCMpEF患者(患者组)及33例健康对照者(对照组)的资料。通过CVI.42软件对CMR图像进行后处理得到左心室的整体及节段PDSR,进而利用相应的统计学方法对上述数据进行分析。结果与对照组相比,患者组的整体及节段PDSR均显著受损(P<0.001)。且在患者组中,全部整体及部分节段PDSR与cTnT显著相关(P<0.05)。其中整体径向PDSR(global radial PDSR,GR-PDSR;r=0.568,P<0.001)与之相关性最好,呈中等相关。经过受试者工作特征曲线分析得知,GR-PDSR(曲线下面积:0.79,敏感度:91%,特异度:65%)具有最佳的cTnT升高的预测能力,其截止值为-1.89 s-1。此外,除心尖部径向PDSR(apical radial PDSR,AR-PDSR)外,整体及节段PDSR均具有较好及以上的组内及组间一致性。结论整体及节段PDSR均能够识别出HCMpEF患者的亚临床心肌损伤及筛选出更为严重的HCMpEF患者,并且可以预测HCMpEF患者的cTnT水平的升高。Objective:To investigate the assessment value of peak diastolic strain rate(PDSR)in hypertrophic cardiomyopathy with preserved ejection fraction(HCMpEF)and its relationship with cardiac troponin T(cTnT).Materials and Methods:The clinical data of 64 HCMpEF patients(patient group)and 33 healthy controls(control group)examined with 3.0 T cardiac magnetic resonance(CMR)(HCMpEF patients were also tested for cTnT)were retrospective analyzed.Global and segment PDSR of left ventricular were obtained by post-processing CMR images with CVI.42 software,and the above data were statistically analyzed with the corresponding statistical analysis methods.Results:Compared with healthy people,all global and segmental PDSR in patient group were significantly damaged(P<0.001).And in patient group,all global and some segmental PDSR were significantly related to cTnT.Among them,the best correlation with cTnT was global radial PDSR(GR-PDSR;r=0.568,P<0.001),with medium-related.Analysis through the receiver operating characteristic curve,GR-PDSR[area under the curve(AUC):0.79,sensitivity:91%,specificity:65%]showed the highest predictive value for elevated cTnT in all PDSR.In addition,all global and segmental PDSR except apical radial PDSR(AR-PDSR)demonstrated moderate and above intra-and inter-observer reproducibility.Conclusions:Global and segmental PDSR can identify sub-clinical myocardial damage in HCMpEF patients and screen out more severe HCMpEF patients,and can also predict the increase of cTnT level in HCMpEF patients.

关 键 词：肥厚型心肌病 心肌肌钙蛋白T 舒张期峰值应变率 射血分数 心脏磁共振 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]