CMR T1mapping and strain analysis in idiopathic inflammatory myopathy: evaluation in patients with negative late gadolinium enhancement and preserved ejection fraction
CMR T1mapping and strain analysis in idiopathic inflammatory myopathy: evaluation in patients with negative late gadolinium enhancement and preserved ejection fraction
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特发性炎症性肌病的 CMR T1 映射和应变分析：对晚期钆增强阴性且射血分数保留的患者进行评估
DOI：
10.1007/s00330-020-07211-y
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发表时间：
2020-09-02
影响因子：
5.9
通讯作者：
Xia, Liming
中科院分区：
文献类型：
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作者：
Zhao, Peijun;Huang, Lu;Xia, Liming
**目的**：探讨心血管磁共振成像（CMR）T1 映射及应变参数能否检测出延迟钆增强（LGE）阴性且射血分数保留的特发性炎性肌病（IIM）患者早期的心肌组织学和功能改变。
**方法**：连续纳入30例无LGE且左心室射血分数（LVEF）未降低的IIM患者（41.5±15.4岁，24例女性），以及30例年龄和性别匹配的健康对照者（40.6±14.2岁，20例女性）。根据高敏肌钙蛋白I（hs - cTnI）值，将IIM患者进一步分为两个亚组：hs - cTnI升高亚组（n = 10）和hs - cTnI正常亚组（n = 20）。对IIM患者和健康对照者的心肌固有T1值、细胞外容积（ECV）分数及应变参数进行分析。
**结果**：与健康对照者相比，IIM患者各左心室节段的固有T1值显著延长，ECV增加（p < 0.05）。在进一步的亚组分析中，左心室中层切片固有T1值区分hs - cTnI升高患者与健康对照者的效能最高（曲线下面积 = 0.92）。IIM患者与对照者之间的左心室整体应变或应变率无显著差异。
**结论**：对于无LGE、LVEF未降低且hs - cTnI未升高的IIM患者，CMR T1映射可检测出弥漫性间质纤维化，这可能是筛查IIM亚临床心脏受累的一种有前景的方法。
Objectives:To investigate whether cardiovascular magnetic resonance (CMR) T1mapping and strain parameters can detect early histological and functional myocardial changes in idiopathic inflammatory myopathy (IIM) with negative late gadolinium enhancement (LGE) and preserved ejection fraction.Methods:Thirty consecutive patients with IIM (41.5 ± 15.4 years, 24 females) who did not have LGE or reduced left ventricular ejection fraction (LVEF) and 30 age- and gender-matched healthy controls (40.6 ± 14.2 years, 20 females) were recruited. Patients with IIM were further classified into two subgroups according to high-sensitivity cardiac troponin I (hs-cTnI) values: elevated hs-cTnI subgroup (n = 10) and normal hs-cTnI subgroup (n = 20). Myocardial native T1values, extracellular volume (ECV) fractions, and strain parameters were analyzed in patients with IIM and healthy controls.Results:Compared with healthy controls, patients with IIM had significantly prolonged native T1values and increased ECV in each LV segment (p < 0.05). In further subgroup analysis, LV mid-slice native T1values had the most power to discriminate between patients with elevated hs-cTnI and healthy controls (area under the curve = 0.92). There was no significant difference of global LV strain or strain rates between IIM patients and controls.Conclusions:Diffuse interstitial fibrosis can be detected by CMR T1mapping in patients with IIM who do not have LGE or reduced LVEF or elevated hs-cTnI, and it may be a promising method for screening subclinical cardiac involvement in IIM.Key points:• Myocardial abnormality in IIM is often subclinical and leads to poor prognosis. • Conventional CMR parameters have limitations in early detection of cardiac function and tissue changes. • CMR T1mapping techniques and myocardial strain analysis have the potential to provide detailed information on cardiac histology and function.