心脏磁共振显像评估肥厚型心肌病患者左心室心肌应变变化  

Evaluation of left ventricular myocardial strain of patients with hypertrophic cardiomyopathy using cardiac magnetic resonance imaging

作　　者：陈晓荣 潘江峰 胡红杰[2] 余日胜[3] CHEN Xiaorong;PAN Jiangfeng;HU Hongjie;YU Risheng(Department of Medical Imaging,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua 321000,China;不详)

机构地区：[1]浙江大学医学院附属金华医院医学影像科,321000 [2]浙江大学医学院附属邵逸夫医院放射科 [3]浙江大学医学院附属第二医院放射科

出　　处：《心电与循环》2023年第2期117-121,共5页Journal of Electrocardiology and Circulation

基　　金：金华市重点科学技术研究计划项目(2021-3-107);国家自然科学基金资助项目(81873908)。

摘　　要：目的应用心脏磁共振显像分析肥厚型心肌病(HCM)患者的左心室心肌应变变化。方法收集浙江大学医学院附属金华医院2013年3月至2021年12月收治的HCM患者189例(HCM组),30名健康者为对照组。利用心脏电影序列进行分析,测量左心室的结构和功能;利用延迟增强序列定量心肌延迟强化(LGE),通过心肌特征追踪模块分析左心室整体应变及局部心肌应变。分析左心室整体、局部心肌应变与心脏结构、LGE的相关性。结果HCM组的左心室整体心肌应变及局部心肌应变的绝对值均较对照组降低(均P<0.05)。HCM组患者的肥厚节段、LGE节段、肥厚且LGE节段的局部心肌应变的绝对值分别较非肥厚节段、非LGE节段、肥厚且非LGE节段降低(均P<0.05)。相关性分析显示,左心室整体径向应变与左心室质量呈负相关(r=-0.52,P<0.05),肥厚节段局部径向应变与LGE呈负相关(r=-0.46,P<0.05)。结论HCM患者的左心室心肌径向应变功能受损,与心肌肥厚及LGE相关。Objective To explore left ventricular myocardial strain in patients with hypertrophic cardiomyopathy(HCM)using cardiac magnetic resonance imaging(CMRI).Methods A total of 189 patients with hypertrophic cardiomyo-pathy(HCM group)and 30 healthy people(control group)were enrolled from March 2013 to December 2021.Left ventricular structure and function were evaluated using CMRI.Late gadolinium enhancement(LGE)sequence was used to calculate myocardial delayed enhancement.Cardiac magnetic resonance tissue tracking was used to analyze global and regional left ventricular myocardial strain.The relation of global and regional myocardial strain with ventricular structure and LGE were assessed.Results The global and regional myocardial strains were significantly lower in HCM group than in the control group(all P<0.05).The regional myocardial strain was significantly lower in hypertrophic segments,enhancement segments and hypertrophic combined enhancement segments than in non-hypertrophic segments,non-enhancement segments and hypertrophic segments without enhancement,respectively(all P<0.05).Correlation analysis showed that global left ventricular radial strain was negatively correlated with left ventricular mass(r=-0.52,P<0.05)and regional radial strain of hypertrophic segments was negatively correlated with LGE(r=-0.46,P<0.05).Conclusion Regional left ventricular myocardial radial strain decreases in patients with HCM and is related to myocardial hypertrophy and LGE.

关 键 词：肥厚型心肌病 磁共振成像 心肌应变 

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]