Cardiac MRI evaluation of hypertrophic cardiomyopathy: left ventricular outflow tract/aortic valve diameter ratio predicts severity of LVOT obstruction.
Cardiac MRI evaluation of hypertrophic cardiomyopathy: left ventricular outflow tract/aortic valve diameter ratio predicts severity of LVOT obstruction.
复制标题
肥厚型心肌病的心脏 MRI 评估：左心室流出道/主动脉瓣直径比可预测 LVOT 梗阻的严重程度。
DOI：
10.1002/jmri.23677
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Bluemke,DavidA
中科院分区：
文献类型：
--
作者：
Vogel-Claussen,Jens;SantaulariaTomas,Miguel;Newatia,Amit;Boyce,Danielle;Pinheiro,Aurelio;Abraham,Roselle;Abraham,Theodore;Bluemke,DavidA
目的评价心脏磁共振（CMR）测量的左心室流出道/主动脉瓣（LVOT/AO）直径比与多普勒超声心动图比较，是否能准确诊断肥厚性心肌病（HCM）患者左心室流出道梗阻。材料与方法将92例HCM患者根据静息超声心动图LVOT压力梯度（PG）分为三组：静息时< 30mmhg（非阻塞性，n= 31），静息时< 30mmhg，激发后> 30mmhg（潜伏性，n= 29），静息时> 30mmhg（阻塞性，n= 32）。在3室稳态自由进动（SSFP） CMR上，LVOT收缩期末尺寸除以舒张末期主动脉瓣直径，计算LVOT/AO直径比。结果3个亚组LVOT/AO直径比（非梗阻性0.60±0.13，潜伏性0.41±0.16，梗阻性0.24±0.09，P< 0.001）差异有统计学意义。LVOT/AO直径比与LVOT压力梯度的对数呈强烈的线性负相关（r= - 0.84，P< 0.001）。检测静息梯度> ~ 30mmhg时，LVOT/AO直径比即受试者工作特征（ROC）曲线下面积为0.91（95%可信区间[CI] 0.85 ~ 0.97）。对于静息和/或诱发梯度bbb30 mmHg的检测，ROC曲线下LVOT/AO直径比面积为0.90 （95% CI 0.84-0.96）。结论LVOT/AO直径比值是评估HCM患者LVOT压力梯度的一种准确、可重复性好、无创且易于使用的CMR指标。j .增效。的原因。成像2012;36:598 - 603。©2012 Wiley期刊公司
PurposeTo evaluate if left ventricular outflow tract/aortic valve (LVOT/AO) diameter ratio measured by cardiac magnetic resonance (CMR) imaging is an accurate marker for LVOT obstruction in patients with hypertrophic cardiomyopathy (HCM) compared to Doppler echocardiography.Materials and MethodsIn all, 92 patients with HCM were divided into three groups based on their resting echocardiographic LVOT pressure gradient (PG): <30 mmHg at rest (nonobstructive,n= 31), <30 mmHg at rest, >30 mmHg after provocation (latent,n= 29), and >30 mmHg at rest (obstructive,n= 32). The end‐systolic dimension of the LVOT on 3‐chamber steady‐state free precession (SSFP) CMR was divided by the end diastolic aortic valve diameter to calculate the LVOT/AO diameter ratio.ResultsThere were significant differences in the LVOT/AO diameter ratio among the three subgroups (nonobstructive 0.60 ± 0.13, latent 0.41 ± 0.16, obstructive 0.24 ± 0.09,P< 0.001). There was a strong linear inverse correlation between the LVOT/AO diameter ratio and the log of the LVOT pressure gradient (r= −0.84,P< 0.001). For detection of a resting gradient >30 mmHg, the LVOT/AO diameter ratio the area under the receiver operating characteristic (ROC) curve was 0.91 (95% confidence interval [CI] 0.85–0.97). For detection of a resting and/or provoked gradient >30 mmHg, the LVOT/AO diameter ratio area under the ROC curve was 0.90 (95% CI 0.84–0.96).ConclusionThe LVOT/AO diameter ratio is an accurate, reproducible, noninvasive, and easy to use CMR marker to assess LVOT pressure gradients in patients with HCM. J. Magn. Reson. Imaging 2012;36:598–603. © 2012 Wiley Periodicals, Inc.