Assessment of reverse remodeling predicted by myocardial deformation on tissue tracking in patients with severe aortic stenosis: a cardiovascular magnetic resonance imaging study.
Assessment of reverse remodeling predicted by myocardial deformation on tissue tracking in patients with severe aortic stenosis: a cardiovascular magnetic resonance imaging study.
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DOI：
10.1186/s12968-017-0392-0
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发表时间：
2017-10-23
期刊：
影响因子：
--
通讯作者：
Park SW
中科院分区：
文献类型：
--
作者：
Hwang JW;Kim SM;Park SJ;Cho EJ;Kim EK;Chang SA;Lee SC;Choe YH;Park SW
介绍了使用平衡稳态自由进动电影序列的组织跟踪技术，并允许直接导出心肌应变，提供了优于传统心肌标记的优势。本研究的目的是评价逆转重构作为一种结果与左心室应变之间的相关性，使用心血管磁共振成像（CMR）组织追踪，并评估预测逆转重构的心肌变形严重主动脉瓣狭窄（AS）患者。我们纳入了63例重度AS和左心室（LV）收缩功能正常（射血分数> 60%）的患者，这些患者在外科主动脉瓣置换术（AVR）前接受了CMR和经胸超声心动图（Echo）。在1.5 T下进行CMR，包括细胞外容积（ECV）的非造影和造影后T1标测，以确定心肌纤维化的量。使用心脏性能分析软件从三个短轴电影视图（基底、中间和心尖水平）和心尖2、3和4腔视图推导心肌变形作为应变参数。主要结果是逆转重构，通过左心室质量指数（LVMI）的回归进行评估。中位随访时间为28.8个月（四分位距11.3-38.3个月）。根据基线和随访之间的LVMI评估，主动脉瓣置换术后质量回归显著改善（基线145.9 ± 37.0 [g/m2] vs.随访97.7 ± 22.2[g/m2]，p < 0.001）。观察到纵向整体应变（r =-0.461，p < 0.001）、径向应变（r = 0.391，p = 0.002）和周向应变（r =-0.334，p = 0.009）与LVMI回归的Pearson相关性具有统计学显著性。简单线性回归分析显示，所有应变参数均可预测LVMI消退量（P < 0.05），以及非造影T1值（β = −0.314，p < 0.001）和ECV（β = −2.546，p = 0.038）。然而，ECV具有最低的预测能力（倍数r2 = 0.071）。多元回归分析显示，应变可以独立预测LVMI回归量和纵向整体应变（β =-3.335，p < 0.001）。通过CMR组织追踪测量的纵向整体应变作为一种技术与LVMI回归时的反向重构相关，并可预测该结果。作为一种简单实用的方法，组织跟踪有希望评估应变和预测严重AS的逆向重构，特别是在回声图像质量欠佳的患者中。本文的在线版本（10.1186/s12968-017-0392-0）包含补充材料，可供授权用户使用。
The technique of tissue tracking with balanced steady-state free precession cine sequences was introduced, and allowed myocardial strain to be derived directly, offering advantages over traditional myocardial tagging. The aim of this study was to evaluate the correlation between reverse remodeling as an outcome and left ventricular strain using cardiovascular magnetic resonance imaging (CMR) tissue tracking, and to evaluate prediction of reverse remodeling by myocardial deformation in patients with severe aortic stenosis (AS). We enrolled 63 patients with severe AS and normal left ventricular (LV) systolic function (ejection fraction > 60%), who underwent both CMR and transthoracic echocardiography (Echo) before surgical aortic valve replacement (AVR). CMR at 1.5 T, including non and post-contrast T1 mapping for extracellular volume (ECV), was carried out to define the amount of myocardial fibrosis. Cardiac Performance Analysis software was used to derive myocardial deformation as strain parameters from three short-axis cine views (basal, mid and apical levels) and apical 2, 3, and 4 chamber views. The primary outcome was reverse remodeling, as evaluated by regression of left ventricular mass index (LVMI). Median follow-up was 28.8 months (interquartile range 11.3–38.3 months). As evaluated by LVMI between baseline and follow-up, mass regression was significantly improved after AVR (baseline 145.9 ± 37.0 [g/m2] vs. follow-up 97.7 ± 22.2[g/m2], p < 0.001). Statistically significant Pearson’s correlations with LVMI regression were observed for longitudinal global strain (r = −0.461, p < 0.001), radial strain (r = 0.391, p = 0.002), and circumferential strain (r = −0.334, p = 0.009). A simple linear regression analysis showed that all strain parameters could predict the amount of LVMI regression (P < 0.05), as well as non-contrast T1 value (beta = −0.314, p < 0.001) and ECV (beta = −2.546, p = 0.038). However, ECV had the lowest predictive power (multiple r2 = 0.071). Multiple regression analysis showed strain could independently predict the amount of LVMI regression and the longitudinal global strain (beta = −3.335, p < 0.001). Longitudinal global strain measured by CMR tissue tracking as a technique was correlated with reverse remodeling as LVMI regression and was predictive of this outcome. As a simple and practical method, tissue tracking is promising to assess strain and predict reverse remodeling in severe AS, especially in patients with suboptimal Echo image quality. The online version of this article (10.1186/s12968-017-0392-0) contains supplementary material, which is available to authorized users.
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影响因子：
5.7
作者：
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影响因子：
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作者：
Díez, J;Querejeta, R;Ubago, JLM
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Ubago, JLM
DOI：
10.1016/j.jtcvs.2011.11.017
发表时间：
2012-09-01
影响因子：
6
作者：
Breitenbach, Ingo;Harringer, Wolfgang;Gerosa, Gino
通讯作者：
Gerosa, Gino