The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy patients with or without left ventricular outflow tract obstruction: Assessment with first-pass perfusion imaging using 3.0-T cardiac magnetic resonance
The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy patients with or without left ventricular outflow tract obstruction: Assessment with first-pass perfusion imaging using 3.0-T cardiac magnetic resonance
复制标题
伴或不伴左心室流出道梗阻的肥厚型心肌病患者局部心肌微血管功能障碍的差异：使用 3.0-T 心脏磁共振的首过灌注成像评估
DOI：
10.1016/j.ejrad.2014.01.008
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发表时间：
2014-04-01
影响因子：
3.3
通讯作者：
Guo, Ying-kun
中科院分区：
文献类型：
--
作者：
Xu, Hua-yan;Yang, Zhi-gang;Guo, Ying-kun
目的：采用3.0-T心脏磁共振（CMR）首过灌注成像评价肥厚型心肌病（HCM）伴或不伴左室流出道梗阻患者局部心肌微血管功能障碍的差异。材料和方法：HCM患者42例，其中左室流出道梗阻（HOCM）25例，无左室流出道梗阻（NOHCM）17例，14例健康受试者行CMR。测量并计算左室功能、左室舒张末期室壁厚度（EDTH）和左室流出道内径（LVOT）。结果：HCM患者首过心肌灌注显像的上升斜率、峰值强度和达峰时间均低于正常对照组（P均<0.05），峰值强度低于正常对照组（P均< 0.05），达峰时间长于正常对照组（P均< 0.05）。与NOHCM组相比，HOCM组的平均达峰时间增加（13.30 +/- 4.82 s vs 16.28 +/- 4.90 s，p < 0.05），但首过灌注上升斜率减少（4.96 +/- 2.55 vs 2.58 +/- 0.77，p < 0.05）。根据牛眼模型，HOCM组的基底节段的平均厚度比NOHCM组厚，尤其是前间隔、下外侧和前壁值，相应的首过灌注上升斜率比NOHCM组低（均p < 0.05）。结论：首过灌注CMR显像可反映肥厚型心肌病（HCM）患者左室流出道梗阻与非梗阻心肌微血管功能的差异。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Purpose: To assess regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy (HCM) patients with or without left ventricular outflow tract obstruction using 3.0-T cardiac magnetic resonance (CMR) first-pass perfusion imaging.Materials and methods: Forty-two HCM patients, including 25 HCM patients with left ventricular outflow tract obstruction (HOCM), 17 HCM patients without left ventricular outflow tract obstruction (NOHCM), and 14 healthy subjects underwent CMR. The left ventricular (LV) function, left ventricular end-diastolic wall thickness (EDTH), and diameter of left ventricular outflow tract (LVOT) were measured and calculated. Based on the signal-time curve of the first-pass myocardium perfusion imaging, perfusion parameters including upslope, time to peak, and peak intensity, were assessed and compared by using one-way analysis of variance and independent t tests.Results: On the first-pass perfusion imaging, lower upslope and peak intensity and longer time to peak were found in HCM patients compared with normal subjects (all p < 0.05). In contrast to the NOHCM group, the average time to peak of the HOCM group was increased (13.30 +/- 4.82 s vs 16.28 +/- 4.90 s, p < 0.05), but first-pass perfusion upslope was reduced (4.96 +/- 2.55 vs 2.58 +/- 0.77, p < 0.05). According to the bull's-eye model, the HOCM group's average thickness of basal segments was thicker than the NOHCM group, especially the anteroseptal, inferolateral, and anterior wall values, with a corresponding lower first-pass perfusion upslope than the NOHCM group (all p < 0.05). A significant correlation was observed between first-pass perfusion upslope and LV EDTH (r = -0.551, p < 0.001) and LVOT diameter (r = 0.472, p < 0.001).Conclusions: The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy (HCM) patients with or without left ventricular outflow tract obstruction can be detected with first-pass perfusion CMR imaging. (C) 2014 Elsevier Ireland Ltd. All rights reserved.