Effect of systemic sclerosis on left ventricular long-axis motion and left ventricular mass assessed by magnetic resonance
Effect of systemic sclerosis on left ventricular long-axis motion and left ventricular mass assessed by magnetic resonance
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DOI：
10.3109/10976640009148679
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发表时间：
2000-01-01
影响因子：
6.4
通讯作者：
Pennell, DJ
中科院分区：
文献类型：
--
作者：
Karwatowski, SP;Chronos, NA;Pennell, DJ
本研究的目的是评估硬皮病对左心室质量和心内膜下功能的影响，使用心血管磁共振（CMR）来确定反映纤维化早期功能障碍的参数。15例有硬皮病病史的患者，采用标准技术测量左心室质量，并采用长轴敏化速度标测的基础短轴平面心肌速度标测评估局部内膜下收缩功能。测量心肌收缩期和舒张期峰值运动速度，反映收缩和舒张功能。局部心肌速度的变化被确定为心室周围功能异质性的参数。研究结果与19名无心血管疾病史的健康志愿者进行了比较。在10例患者中，使用单次呼吸氦稀释技术测量肺转移因子。硬皮病病程与左室重量（r = 0.7，p < 0.05）、左室舒张期长轴速度变异系数（r = 0.63，p < 0.05）呈负相关（r =-0.63，p < 0.05）。左室舒张期长轴速度与肺转移因子也有相关性（r = 0.7，p < 0.05）。趋势表明对照受试者和硬皮病患者之间的平均收缩（64与49 mm/sec，p = 0.09）和舒张（90与72 mm/sec，p = 0.07）速度以及速度方差（26与33，p = 0.09）存在差异。总之，硬皮病病程与左心室质量和舒张功能之间存在关系，这可能是由于心肌纤维化增加所致。趋势表明，与对照受试者的功能值存在绝对差异，反映了舒张和收缩功能受损，区域异质性更大，与不均匀的胶原沉积一致，但需要更大的样本量来证实这一点。CMR应作为一种无创性监测硬皮病心肌受累的技术进一步探索。
The aim of this study was to assess the effect of scleroderma on left ventricular mass and subendocardial function using cardiovascular magnetic resonance (CMR) to determine parameters reflecting early dysfunction from fibrosis. Fifteen patients,vith a history of scleroderma had left ventricular mass measured with standard techniques and regional subendocardial contractile function assessed using myocardial velocity mapping in the basal short-axis plane with long-axis sensitized velocity mapping. Peak myocardial velocities in systole and diastole were measured to reflect systolic and diastolic function. The variance in the regional myocardial velocity was determined as a parameter of function heterogeneity around the ventricle. The results were compared with 19 healthy volunteers without a history of cardiovascular disease. In 10 patients, pulmonary transfer-factor was measured using a single-breath helium dilution technique. The duration of scleroderma correlated with left ventricular mass (r = 0.7, p < 0.05), the coefficient of variation of velocity (r = 0.63, p < 0.05), and inversely with the mean left ventricular diastolic long-axis velocity (r = -0.63, p < 0.05). There was also a correlation between left ventricular diastolic long-axis velocity and the pulmonary transfer factor (r = 0.7, p < 0.05). Trends suggested differences between control subjects and scleroderma patients for mean systolic (64 vs. 49 mm/sec, p = 0.09) and diastolic (90 vs. 72 mm/sec, p = 0.07) velocities, as well as velocity variance (26 vs. 33, p = 0.09). in conclusion, there is a relationship between duration of scleroderma and both left ventricular mass and diastolic function, which may result from increased myocardial fibrosis. Trends suggest absolute differences in functional values with control subjects that reflect impaired diastolic and systolic function, with greater regional heterogeneity that is consistent with nonuniform collagen deposition, bur a larger sample size is required to confirm this. CMR should be explored further as a technique for monitoring myocardial involvement in scleroderma noninvasively.