目的 探索心脏磁共振(cardiac magnetic resonance,CMR)技术在肥厚型心肌病(hypertrophic cardiomyopathy,HCM)患者左心房(left atrium,LA)心肌形变评估中的应用价值.材料与方法 回顾性分析2020年1月至2023年10月于我院就诊的45例HCM患者的临床资料,患者接受超声心动图检查,根据左心室射血分数(left ventricular ejection fraction,LVEF)将其分为正常组31例(55％≤LVEF<70％)和异常组14例(LVEF<55％),并选取于我院行心脏检查的健康体检者45例为对照组,收集三组的一般资料和CMR检查的影像资料,比较三组心功能指标和LA心肌形变指标,采用Pearson相关性分析心功能指标和LA心肌形变指标间的相关性,并采用受试者工作特征(receiver operating characteristic,ROC)曲线分析心肌形变指标对HCM的诊断价值.结果 三组性别、年龄、身体质量指数(body mass index,BMI)、心指数之间差异无统计学意义(P>0.05),正常组和异常组LA最大容积(LA maximum volume,LAVmax)、LA最小容积(LA minimum volume,LAVmin)高于对照组,左房总射血分数(left atrial total ejection fraction,LATEF)、心排出量和LVEF低于对照组,且异常组LAVmax和LAVmin高于正常组,每搏输出量低于正常组和对照组(P<0.05).正常组和异常组储存应变和泵应变低于对照组(P<0.05),心肌形变指标储存应变和泵应变与LAVmax和LAVmin呈负相关性(r=−0.605～−0.573,P<0.05),与LATEF、心排出量、每搏输出量、心指数和LVEF呈正相关性(r=0.521～0.669,P<0.05).经ROC曲线分析发现,储存应变和泵应变诊断HCM的AUC分别为0.714、0.699,其联合诊断的AUC为0.820,敏感度和特异度分别为74.2％和78.6％(P<0.05).结论 CMR技术在HCM患者LA心肌形变中有较高的评估价值,通过评估LA心肌形变能辅助诊断HCM,同时评估其心功能情况.
Preliminary study on the assessment of left atrial myocardial deformation in patients with hypertrophic cardiomyopathy using CMR technology
Objective:To explore the application value of cardiac magnetic resonance (CMR) technology in the assessment of left atrium (LA) myocardial deformation in patients with hypertrophic cardiomyopathy (HCM). Materials and Methods:The clinical data of 45 HCM patients who were treated in our hospital from January 2020 to October 2023 were retrospectively analyzed. The patients underwent echocardiography and were divided into categories according to left ventricular ejection fraction (LVEF). There were 31 cases in the normal group (55％≤LVEF<70％) and 14 cases in the abnormal group (LVEF<55％). A total of 45 healthy subjects who underwent cardiac examinations in our hospital were selected as the control group. Three groups of general information and the imaging data of the CMR examination were compared between the three groups of cardiac function indicators and LA myocardial deformation indicators. Pearson correlation was used to analyze the correlation between cardiac function indicators and LA myocardial deformation indicators,and the receiver operating characteristic (ROC) curve was used. Curve analysis of the diagnostic value of myocardial deformation indicators for HCM. Results:There was no statistically significant difference in gender,age,body mass index (BMI),and cardiac index among the three groups (P>0.05). The LA maximum volume (LA maximum volume,LAVmax) and LA were the smallest in the normal group and the abnormal group. The volume (LA minimum volume,LAVmin) was higher than that of the control group,the left atrial total ejection fraction (LATEF),cardiac output and LVEF were lower than those of the control group,and the LAVmax and LAVmin of the abnormal group were higher than those of the normal group. The stroke volume was lower than that in the normal group and control group (P<0.05). The storage strain and pump strain in the normal group and the abnormal group were lower than those in the control group (P<0.05). The storage strain and pump strain of the myocardial deformation indexes were negatively correlated with LAVmax and LAVmin (r=−0.605–−0.573,P<0.05). There was a positive correlation with LATEF,cardiac output,stroke volume,cardiac index and LVEF (r=0.521–0.669,P<0.05). ROC curve analysis found that the AUC of storage strain and pump strain in diagnosing HCM were 0.714 and 0.699 respectively,and the AUC of their combined diagnosis was 0.820. The sensitivity and specificity were 74.2％ and 78.6％ respectively (P<0.05). Conclusions:CMR technology has high evaluation value in LA myocardial deformation in HCM patients. By evaluating LA myocardial deformation,it can assist in the diagnosis of HCM and also evaluate their cardiac function.
cardiac magnetic resonancehypertrophic cardiomyopathymyocardial deformationejection functioncardiac functionmagnetic resonance imaging
万方数据
维普
