Early changes of pulmonary arterial hemodynamics in patients with systemic sclerosis: flow pattern, WSS, and OSI analysis with 4D flow MRI
Early changes of pulmonary arterial hemodynamics in patients with systemic sclerosis: flow pattern, WSS, and OSI analysis with 4D flow MRI
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DOI：
10.1007/s00330-020-07301-x
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发表时间：
2020-11-19
影响因子：
5.9
通讯作者：
Maekawa, Yuichiro
中科院分区：
文献类型：
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作者：
Ikoma, Takenori;Suwa, Kenichiro;Maekawa, Yuichiro
目的应用4D-Flow磁共振成像技术(4D-Flow)研究系统性硬化症(SSC)患者的肺动脉血流动力学。方法对23例SSc患者(男性2/21，57+/-15岁，3例右心导管显示为PA高血压(PAH))和10例正常对照(男性/女性：1/9，55+/-17岁)进行了4D-FLOW活体测量PA的三维血流速度。数据分析包括面积平均流动量化、三维壁面剪切应力(WSS)、沿PA表面的振荡剪切指数(OSI)计算和雷诺数。对全因死亡和主要不良心脏事件的综合结果也进行了调查。结果SSc患者收缩期主动脉最大流量与对照组相比差异无统计学意义，但舒张期最小流量显著高于对照组(7.70±16.0ml/S vs-13.0+/-17.3ml/S，p<；0.01)。与正常对照组比较，SSc患者收缩末期最大WSS显著降低(1.04±0.20Pavs.1.33±0.34Pavs.1.33±0.34Pavs.1.33±0.34Pavs.0.101+/-0.037，P<0.01)，OSI显著增加(0.101+/-0.037，p<0.01)。在主动脉血流最少的患者中，复合事件的累积无事件发生率显著较低
Objectives To study the pulmonary artery (PA) hemodynamics in patients with systemic sclerosis (SSc) using 4D flow MRI (4D-flow). Methods Twenty-three patients with SSc (M/F: 2/21, 57 +/- 15 years, 3 manifest PA hypertension (PAH) by right heart catheterization) and 10 control subjects (M/F: 1/9, 55 +/- 17 years) underwent 4D-flow for the in vivo measurement of 3D blood flow velocities in the PA. Data analysis included area-averaged flow quantification at the main PA, 3D wall shear stress (WSS), oscillatory shear index (OSI) calculation along the PA surface, and Reynolds number. The composite outcome of all-cause death and major adverse cardiac events was also investigated. Results The maximum PA flow at the systole did not differ, but the minimum flow at the diastole was significantly greater in patients with SSc compared with that in control subjects (7.7 +/- 16.0 ml/s vs. - 13.0 +/- 17.3 ml/s, p < 0.01). The maximum WSS at the peak systole was significantly lower and OSI was significantly greater in patients with SSc compared with those in control subjects (maximum WSS: 1.04 +/- 0.20 Pa vs. 1.33 +/- 0.34 Pa, p < 0.01, OSI: 0.139 +/- 0.031 vs. 0.101 +/- 0.037, p < 0.01). The cumulative event-free rate for the composite event was significantly lower in patients with minimum flow in main PA