Increased extracellular volume and altered mechanics are associated with LVH in hypertensive heart disease, not hypertension alone.
Increased extracellular volume and altered mechanics are associated with LVH in hypertensive heart disease, not hypertension alone.
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DOI：
10.1016/j.jcmg.2014.09.020
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发表时间：
2015-02
影响因子：
14
通讯作者：
Salerno, Michael
中科院分区：
文献类型：
--
作者：
Kuruvilla, Sujith;Janardhanan, Rajesh;Antkowiak, Patrick;Keeley, Ellen C.;Adenaw, Nebiyu;Brooks, Jeremy;Epstein, Frederick H.;Kramer, Christopher M.;Salerno, Michael
关键词：
评估高血压伴左心室肥厚（HTN LVH）、高血压不伴LVH（HTN Non-LVH）和正常血压对照组的细胞外容积（ECV）、天然T1和收缩期应变之间的关系。HTN LVH患者的弥漫性心肌纤维化（如ECV和天然T1增加所反映）可能是与HTN非LVH受试者和对照组相比导致心血管风险增加的潜在机制。此外，与其他两组相比，HTN LVH受试者中弥漫性纤维化增加可能与收缩期峰值和舒张早期应变率降低相关。在Siemens 1.5T Avanto上使用先前确认的MOLLI脉冲序列对20例HTN LVH（55±11岁）、23例HTN非LVH（61±12岁）和22例对照（54±7岁）受试者进行T1标测。T1分别在造影前和注射0.15 mmol/kg Gd-DTPA后10、15和20 min测量，并测定每例受试者的平均ECV和天然T1。使用具有刺激回波的电影位移编码（DENSE）进行周向应变参数的测量。与对照组相比，HTN LVH受试者具有更高的天然T1（p < 0.05）。当与HTN非LVH受试者和对照相比时，HTN LVH受试者具有更高的ECV（p < 0.05）。与HTN Non-LVH受试者和对照组相比，HTN LVH受试者的收缩期峰值周向应变和舒张早期应变率降低（p < 0.05）。在所有受试者中，ECV和天然T1水平升高与收缩期峰值和舒张早期周向应变率降低相关。与HTN非LVH和对照受试者相比，HTN LVH患者的ECV更高，天然T1更长，收缩期峰值周向应变和舒张早期应变率降低。ECV和天然T1的测量提供了高血压心脏病弥漫性纤维化的非侵入性评估。
To assess the relationship between extracellular volume (ECV), native T1, and systolic strain in hypertensive patients with left ventricular hypertrophy (HTN LVH), hypertensive patients without LVH (HTN Non-LVH) and normotensive controls. Diffuse myocardial fibrosis in HTN LVH patients, as reflected by increased ECV and native T1, may be an underlying mechanism contributing to increased cardiovascular risk when compared to HTN Non-LVH subjects and controls. Furthermore increased diffuse fibrosis in HTN LVH subjects may be associated with reduced peak systolic and early diastolic strain rate when compared to the other two groups. T1 mapping was performed in 20 HTN LVH (55±11 years), 23 HTN Non-LVH (61±12) and 22 control (54±7) subjects on a Siemens 1.5T Avanto using a previously validated MOLLI pulse sequence. T1 was measured pre-contrast and 10, 15 and 20 minutes following injection of 0.15 mmol/kg Gd-DTPA, and the mean ECV and native T1 were determined for each subject. Measurement of circumferential strain parameters were performed using cine displacement encoding with stimulated echoes (DENSE). HTN LVH subjects had higher native T1 when compared to controls (p < 0.05). HTN LVH subjects had higher ECV when compared to HTN Non-LVH subjects and controls (p < 0.05). Peak systolic circumferential strain and early diastolic strain rate were reduced in HTN LVH subjects when compared to HTN Non-LVH subjects and controls (p < 0.05). Increased levels of ECV and Native T1 were associated with reduced peak systolic and early diastolic circumferential strain rate across all subjects. HTN LVH patients had higher ECV, longer native T1 and associated reduction in peak systolic circumferential strain and early diastolic strain rate when compared to HTN Non-LVH and control subjects. Measurement of ECV and native T1 provide a non-invasive assessment of diffuse fibrosis in hypertensive heart disease.
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影响因子：
37.8
作者：
PALMON, LC;REICHEK, N;AXEL, L
通讯作者：
AXEL, L
影响因子：
7.5
作者：
Mascherbauer, Julia;Marzluf, Beatrice A.;Bonderman, Diana
通讯作者：
Bonderman, Diana
影响因子：
120.7
作者：
Levy, D;Larson, MG;Ho, KKL
通讯作者：
Ho, KKL
影响因子：
3.2
作者：
MCLENACHAN, JM;DARGIE, HJ
通讯作者：
DARGIE, HJ
影响因子：
24
作者：
Olivotto, Iacopo;Maron, Martin S.;Maron, Barry J.
通讯作者：
Maron, Barry J.