心脏磁共振特征追踪定量分析心尖肥厚型心肌病早期左心房功能异常  

Quantitative analysis of abnormal left atrial function in the early stages of apical hypertrophic cardiomyopathy by cardiac magnetic resonance feature tracking

作　　者：汤茜 黄涛[1] 谭盈盈 杨映霞 TANG Qian;HUANG Tao;TAN Yingying;YANG Yingxia(Department of Radiology,Guangxi Hospital Division of The First Affiliated Hospital,Sun Yat-sen University,Guangxi 530000,China;Department of Radiology,The People’s Hospital of Guangxi Zhuang Autonomous Region,Guangxi 530021,China)

机构地区：[1]中山大学附属第一医院广西医院放射影像科,广西南宁530000 [2]广西壮族自治区人民医院放射科,广西南宁530021

出　　处：《影像诊断与介入放射学》2025年第1期29-35,共7页Diagnostic Imaging & Interventional Radiology

基　　金：广西自然科学基金面上项目(2021GXNSFAA196062);广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016577);广西壮族自治区卫生健康委自筹经费科研课题(Z-A20240169)。

摘　　要：目的采用心脏磁共振特征追踪技术对心尖肥厚型心肌病患者早期左心房功能障碍进行定量评估。方法回顾性分析2020年2月—2023年12月80例本院诊断心尖肥厚型心肌病患者和42例正常对照组的临床资料、心脏磁共振基本参数、左心房功能参数。根据室壁厚度是否大于等于15 mm将患者分为临床组、亚临床组。对三组的临床和心脏磁共振参数进行系统性对比分析。结果与对照组相比,临床组和亚临床组心尖肥厚型心肌病患者左心房存储功能及导管功能的射血分数均明显减小(P<0.01)[总射血分数:(46.5±13.2)%和(48.4±12.9)%比(58.4±10.7)%,被动射血分数:(20.4±10.0)%和(21.7±9.4)%比(31.0±9.9)%]、应变[总应变:(31.0±11.5)%和(33.8±14.3)%比(41.7±11.5)%,被动应变:(15.3±8.3)%和(16.1±8.2)%比(22.3±8.0)%]及应变率[正向峰值应变率:(1.3±0.5)s-1和(1.4±0.7)s-1比(1.8±0.8)s-1,早期负向峰值应变率:(-0.8±0.6)s-1和(-1.0±1.2)s-1比(-1.4±0.9)s-1],但临床组与亚临床组组间对比差异无统计学意义。临床组助力泵功能中的晚期负向峰值应变率较对照组及亚临床组减小(P<0.01)。相关分析显示左心房储血功能、导管功能与左心室心脏指数、最大室壁厚度存在相关性(P<0.05)。结论左心房存储及导管功能障碍在心尖肥厚型心肌病患者早期已存在,心脏磁共振特征追踪技术在早期心房功能评估中展现出重要的临床价值。Objective To quantitatively assess early left atrial dysfunction in patients with apical hypertrophic cardiomyopathy using cardiac MR feature tracking.Methods The clinical data,basic cardiac MR parameters,and left atrial function parameters of 80 patients with apical hypertrophic cardiomyopathy and 42 healthy subjects from February 2020 to December 2023 were retrospectively analyzed.The patients were divided into clinical and subclinical groups according to the ventricular wall thickness≥15 mm.The clinical and cardiac MR parameters of the three groups were compared separately.Results In the clinical and subclinical patients,there was significant reduction of total ejection fraction[(46.5±13.2)%,(48.4±12.9)%],passive ejection fraction[(20.4±10.0)%,(21.7±9.4)%],total strain[(31.0±11.5)%,(33.8±14.3)%],passive strain[(15.3±8.3)%,(16.1±8.2)%],positive peak strain rate[(1.3±0.5)s-1,(1.4±0.7)s-1],and early negative peak strain rate[(-0.8±0.6)s-1,(-1.0±1.2)s-1]compared to healthy controls[(58.4±10.7)%,(31.0±9.9)%,(41.7±11.5)%,22.3±8.0,(1.8±0.8)s-1,(-1.4±0.9)s-1]without significant difference between the clinical and subclinical groups.The late negative peak strain rate in booster pump function was significantly reduced in the clinical group than that in control and subclinical group(P≤0.01).There was positive correlation between left atrial storage and conduit function and left ventricular cardiac index and maximal ventricular wall thickness(P<0.05).Conclusion Left atrial storage and conduit dysfunction exist in patients with early apical hypertrophic cardiomyopathy.Cardiac MR feature tracking technology has clinical value in early left atrial function assessment.

关 键 词：心尖肥厚型心肌病 心脏磁共振 特征追踪技术 左心房应变 

分 类 号：R542.2[医药卫生—心血管疾病] R445.2[医药卫生—内科学]