Abnormal Diastolic Hemodynamic Forces: A Link Between Right Ventricular Wall Motion, Intracardiac Flow, and Pulmonary Regurgitation in Repaired Tetralogy of Fallot.
Abnormal Diastolic Hemodynamic Forces: A Link Between Right Ventricular Wall Motion, Intracardiac Flow, and Pulmonary Regurgitation in Repaired Tetralogy of Fallot.
复制标题
DOI：
10.3389/fcvm.2022.929470
复制
发表时间：
2022
影响因子：
3.6
通讯作者：
Olivieri, Laura
中科院分区：
文献类型：
--
作者：
Loke, Yue-Hin;Capuano, Francesco;Kollar, Sarah;Cibis, Merih;Kitslaar, Pieter;Balaras, Elias;Reiber, Johan H. C.;Pedrizzetti, Gianni;Olivieri, Laura
慢性肺反流（PR）对修复性法洛四联症（RTOF）患者右心室功能障碍的影响已被心脏磁共振（CMR）很好地识别。然而，RV壁运动、心内血流和PR之间的联系尚未建立。血流动力学力（HDF）代表心内血容量和心内膜之间交换的全局力，可通过4D血流或新的壁运动数学模型测量。在我们的研究中，我们使用这种新颖的方法在一组RTOF患者中获得HDF，仅使用常规CMR成像。回顾性研究包括有CMR成像的RTOF患者和对照组。对右心室三维模型进行分割，包括右心室流出道（RVOT）。特征跟踪软件（QStrain 2.0, Medis Medical Imaging Systems, Leiden, Netherlands）从长/短轴影像中捕获心内膜轮廓，并用于重建心室壁运动。从运动表面计算全局HDF矢量，然后基于参考（顶点到基底、隔壁到游离壁和隔膜到rvot方向）将其分解为三个方向分量的振幅/脉冲。比较HDF与CMR和运动应激试验参数的相关性。一部分RTOF患者有4D血流，用于获得涡度（用于相关性）和HDF（用于与cine方法比较）。纳入68例RTOF患者和20例对照。RTOF患者舒张期HDF幅值在三个方向均升高（p<0.05）。PR%与膈- rvot HDF振幅/脉冲相关（r = 0.578, p<0.0001, r = 0.508, p<0.0001）。右心室射血分数与整体HDF振幅有中度相关性（r = 0.2916, p = 0.031）。VO2-max与隔壁-游离壁HDF冲量相关（r = 0.536, p = 0.007）。横膈膜-RVOT HDF与RVOT涡度相关（r = 0.4997, p = 0.001）。经Bland-Altman分析，Cine-derived HDF与4D - flow-derived HDF之间没有显著的测量偏倚。RTOF患者舒张期HDF异常与PR、RV功能、运动能力和涡度相关。HDF可以来源于传统的电影，是RTOF患者右心室壁运动和PR引起的心内血流之间的潜在联系。
The effect of chronic pulmonary regurgitation (PR) on right ventricular (RV) dysfunction in repaired Tetralogy of Fallot (RTOF) patients is well recognized by cardiac magnetic resonance (CMR). However, the link between RV wall motion, intracardiac flow and PR has not been established. Hemodynamic force (HDF) represents the global force exchanged between intracardiac blood volume and endocardium, measurable by 4D flow or by a novel mathematical model of wall motion. In our study, we used this novel methodology to derive HDF in a cohort of RTOF patients, exclusively using routine CMR imaging. RTOF patients and controls with CMR imaging were retrospectively included. Three-dimensional (3D) models of RV were segmented, including RV outflow tract (RVOT). Feature-tracking software (QStrain 2.0, Medis Medical Imaging Systems, Leiden, Netherlands) captured endocardial contours from long/short-axis cine and used to reconstruct RV wall motion. A global HDF vector was computed from the moving surface, then decomposed into amplitude/impulse of three directional components based on reference (Apical-to-Basal, Septal-to-Free Wall and Diaphragm-to-RVOT direction). HDF were compared and correlated against CMR and exercise stress test parameters. A subset of RTOF patients had 4D flow that was used to derive vorticity (for correlation) and HDF (for comparison against cine method). 68 RTOF patients and 20 controls were included. RTOF patients had increased diastolic HDF amplitude in all three directions (p<0.05). PR% correlated with Diaphragm-RVOT HDF amplitude/impulse (r = 0.578, p<0.0001, r = 0.508, p < 0.0001, respectively). RV ejection fraction modestly correlated with global HDF amplitude (r = 0.2916, p = 0.031). VO2–max correlated with Septal-to-Free Wall HDF impulse (r = 0.536, p = 0.007). Diaphragm-to-RVOT HDF correlated with RVOT vorticity (r = 0.4997, p = 0.001). There was no significant measurement bias between Cine-derived HDF and 4D flow-derived HDF by Bland-Altman analysis. RTOF patients have abnormal diastolic HDF that is correlated to PR, RV function, exercise capacity and vorticity. HDF can be derived from conventional cine, and is a potential link between RV wall motion and intracardiac flow from PR in RTOF patients.
登录
查看更多内容
影响因子：
5.9
作者：
Hirtler D;Garcia J;Barker AJ;Geiger J
通讯作者：
Geiger J
DOI：
10.1023/b:visi.0000043755.93987.aa
发表时间：
2005-02-01
影响因子：
19.5
作者：
Beg, MF;Miller, MI;Younes, L
通讯作者：
Younes, L
影响因子：
24
作者：
Ferraz Cavalcanti, Paulo Ernando;Barros Oliveira Sa, Michel Pompeu;Lima, Ricardo de Carvalho
通讯作者：
Lima, Ricardo de Carvalho
影响因子：
3.5
作者：
Kalaitzidis, Pantelis;Orwat, Stefan;Diller, Gerhard-Paul
通讯作者：
Diller, Gerhard-Paul
影响因子：
3.5
作者：
Avesani, Martina;Borrelli, Nunzia;Di Salvo, Giovanni
通讯作者：
Di Salvo, Giovanni