Myocardial delayed enhancement in pulmonary hypertension: pulmonary hemodynamics, right ventricular function, and remodeling.
Myocardial delayed enhancement in pulmonary hypertension: pulmonary hemodynamics, right ventricular function, and remodeling.
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DOI：
10.2214/ajr.09.4114
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发表时间：
2011-01
期刊：
影响因子：
--
通讯作者：
Vogel-Claussen J
中科院分区：
文献类型：
--
作者：
Shehata ML;Lossnitzer D;Skrok J;Boyce D;Lechtzin N;Mathai SC;Girgis RE;Osman N;Lima JA;Bluemke DA;Hassoun PM;Vogel-Claussen J
本研究的目的是评估MRI确定的右室(RV)附着点间隔延迟强化肿块与右室重构、局部力学改变和可疑肺动脉高压(PH)患者肺血流动力学的关系。对38例可疑PH患者进行了右心导管术和心脏MRI检查。10名年龄和性别匹配的健康志愿者作为对照进行MRI比较。室间隔延迟强化肿块在右室附着点进行量化。用电影图像量化收缩期室间隔偏心指数、整体右室功能和重构指数。分别使用常规标记和快速应变编码的MRI采集来测量对应于延迟增强的部位的峰值收缩期周向和纵向应变。32例确诊为PH。32例PH患者中有31例发现延迟增强，6例怀疑有PH但证实无PH的患者中有1例延迟增强(p=0.001)。对照组未发现延迟增强。延迟强化质量与肺血流动力学相关，右室功能降低，右室重构指数增加，偏心指数降低。多元线性回归分析显示RV质量指数是总延迟强化质量的独立预测因素(p=0.017)。区域分析显示，延迟强化肿块与基底前间隔附着处的纵向应变减少有关(r=0.6，p<；0.01)。回归分析显示，基底纵向应变仍然是基底前间隔止点延迟强化肿块的独立预测因子(p=0.02)。在PH组，右室间隔附着点的总延迟强化负荷是通过右室重构对增加的后负荷作出反应来预测的。前间隔附着处的局部纤维性肿块与基底部局部纵向收缩能力降低有关。
The purpose of this study was to assess predictors of MRI-identified septal delayed enhancement mass at the right ventricular (RV) insertion sites in relation to RV remodeling, altered regional mechanics, and pulmonary hemodynamics in patients with suspected pulmonary hypertension (PH). Thirty-eight patients with suspected PH were evaluated with right heart catheterization and cardiac MRI. Ten age- and sex-matched healthy volunteers acted as controls for MRI comparison. Septal delayed enhancement mass was quantified at the RV insertions. Systolic septal eccentricity index, global RV function, and remodeling indexes were quantified with cine images. Peak systolic circumferential and longitudinal strain at the sites corresponding to delayed enhancement were measured with conventional tagging and fast strain-encoded MRI acquisition, respectively. PH was diagnosed in 32 patients. Delayed enhancement was found in 31 of 32 patients with PH and in one of six patients in whom PH was suspected but proved absent (p = 0.001). No delayed enhancement was found in controls. Delayed enhancement mass correlated with pulmonary hemodynamics, reduced RV function, increased RV remodeling indexes, and reduced eccentricity index. Multiple linear regression analysis showed RV mass index was an independent predictor of total delayed enhancement mass (p = 0.017). Regional analysis showed delayed enhancement mass was associated with reduced longitudinal strain at the basal anterior septal insertion (r = 0.6, p < 0.01). Regression analysis showed that basal longitudinal strain remained an independent predictor of delayed enhancement mass at the basal anterior septal insertion (p = 0.02). In PH, total delayed enhancement burden at the RV septal insertions is predicted by RV remodeling in response to increased afterload. Local fibrosis mass at the anterior septal insertion is associated with reduced regional longitudinal contractility at the base.
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影响因子：
19.7
作者：
Moore, CC;Lugo-Olivieri, CH;Zerhouni, EA
通讯作者：
Zerhouni, EA
DOI：
10.1016/s0735-1097(85)80433-2
发表时间：
1985-01-01
影响因子：
24
作者：
RYAN, T;PETROVIC, O;ARMSTRONG, WF
通讯作者：
ARMSTRONG, WF
影响因子：
2.8
作者：
Sanz, Javier;Dellegrottaglie, Santo;Rajagopalan, Sanjay
通讯作者：
Rajagopalan, Sanjay
影响因子：
39.3
作者：
Blyth, KG;Groenning, BA;Peacock, AJ
通讯作者：
Peacock, AJ
影响因子：
24
作者：
Ingkanisorn, WP;Rhoads, KL;Arai, AE
通讯作者：
Arai, AE