MRI native T1 and T2 mapping of myocardial segments in hypertrophic cardiomyopathy: tissue remodeling manifested prior to structure changes
MRI native T1 and T2 mapping of myocardial segments in hypertrophic cardiomyopathy: tissue remodeling manifested prior to structure changes
复制标题
肥厚型心肌病心肌节段的 MRI 原始 T1 和 T2 映射：组织重塑先于结构变化
DOI：
10.1259/bjr.20190634
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发表时间：
2019-01-01
影响因子：
2.6
通讯作者：
Tao, Qian
中科院分区：
文献类型：
--
作者：
Huang, Lu;Ran, Lingping;Tao, Qian
**目的**：本研究旨在通过磁共振成像（MRI）T1和T2 映射技术检测肥厚型心肌病（HCM）患者的局部心肌节段，探究HCM中组织重构与结构和功能重构之间的相关性。
**方法**：本研究纳入47例HCM患者和19名健康志愿者。所有受试者均接受3.0T心脏MRI检查。依据美国心脏协会模型，评估左心室各节段的固有T1和T2值、舒张末期室壁厚度（EDTH）以及收缩期室壁增厚率（PSWT）。根据EDTH将心肌节段分为正常、非肥厚、轻度肥厚、中度肥厚和重度肥厚。评估五组之间的差异，以及固有T1和T2值、EDTH与PSWT之间的相关性。
**结果**：与对照组相比，HCM患者非肥厚节段和肥厚节段的固有T1和T2值均显著升高（均p < 0.001）。非肥厚节段的PSWT保持正常（p = 0.838），而肥厚节段的PSWT显著受损（p < 0.001）。HCM患者重度肥厚节段的固有T1值显著高于轻度和中度肥厚节段（p < 0.05）。
**结论**：在HCM患者中，尽管非肥厚心肌节段的室壁厚度正常且收缩功能保留，但其T1和T2值已显著升高。这一发现表明，在HCM中组织重构可能先于形态和功能重构。MRI固有T1和T2映射可为HCM的早期诊断提供更多价值。
**知识进展**：通过MRI固有T1和T2映射检测到，HCM患者的心肌组织重构早于形态和功能改变。
Objective: The aim of this study was to examine the local myocardial segments in hypertrophic cardiomyopathy (HCM) by MRI T1 and T2 mapping, and to investigate how tissue remodeling correlates with structural and functional remodeling in HCM.Methods: 47 patients with HCM and 19 healthy volunteers were enrolled in this study. All subjects underwent cardiac MRI at 3.0 T. Native T1 and T2 values, end-diastolic wall thickness (EDTH), and percentage of systolic wall thickening (PSWT) were assessed in the left ventricular segments according to the American Heart Association model. Myocardial segments were categorized as normal, non-hypertrophic, mild-hypertrophic, moderate-hypertrophic, and severe-hypertrophic based on EDTH. The difference among all five groups, and the correlation between native T1 and T2 values, EDTH, and PSWT were evaluated.Results: Native T1 and T2 values were significantly elevated in both non-hypertrophic and hypertrophic segments of HCM patients compared to controls (both p < 0.001). PSWT was preserved in non-hypertrophic segments (p = 0.838), while significantly impaired < 0.001) in hypertrophic segments. Native T1 value of severe hypertrophic segments in HCM was significantly higher than segments of mild and moderate hypertrophy (p < 0.05).Conclusion: In HCM patients, the non-hypertrophic myocardial segments already demonstrated significantly elevated T1 and T2 values, despite normal wall thickness and preserved contraction function. The finding suggests that tissue remodeling may precede morphological and functional remodeling in HCM. MRI native T1 and T2 mapping can provide additional value for HCM diagnosis at an early stage.Advances in knowledge: Myocardial tissue remodeling, as detected by MRI native T1 and T2 mapping, occurs earlier than morphological and functional changes in HCM patients.