Accuracy of Late Gadolinium Enhancement - Magnetic Resonance Imaging in the Measurement of Left Atrial Substrate Remodeling in Patients With Rheumatic Mitral Valve Disease and Persistent Atrial Fibrillation - A Histopathological Validation Study
Accuracy of Late Gadolinium Enhancement - Magnetic Resonance Imaging in the Measurement of Left Atrial Substrate Remodeling in Patients With Rheumatic Mitral Valve Disease and Persistent Atrial Fibrillation - A Histopathological Validation Study
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晚期钆增强 - 磁共振成像测量风湿性二尖瓣疾病和持续性心房颤动患者左心房基底重塑的准确性。
DOI：
10.1536/ihj.15-098
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发表时间：
2015-09-01
影响因子：
1.5
通讯作者：
Chen, Yucheng
中科院分区：
文献类型：
--
作者：
Zhu, Da;Wu, Zhong;Chen, Yucheng
本研究的目的是为评估风湿性二尖瓣疾病和持续性心房颤动 (AF) 患者的左心房 (LA) 基质重塑 (SRM) 提供心脏晚期钆增强 (LGE) 磁共振成像 (MRI) 的组织病理学验证。 纳入接受二尖瓣置换术的心内直视手术的风湿性二尖瓣疾病和持续性 AF 成人患者。术前进行不同信号强度的二维 (2D) 切片和三维 (3D) 全容积 LGE-MRI 以确定 LA-SRM 的范围。术中从 LA 顶和后侧壁获取组织样本，通过 Masson 三色染色和 I/III 型胶原沉积的免疫染色进行病理验证。采用线性回归模型确定MRI衍生的LA-SRM参数与病理结果之间的关系。2013年2月至2014年3月，我们成功采集了22名患者（13名男性）的LA组织样本，平均年龄为47±8岁。所有患者均患有风湿性二尖瓣狭窄，超声心动图平均有效瓣口面积为 0.9 ± 0.2 cm(2)，3D-MRI 平均 LA 体积为 235 ± 85 mL。病理结果与 LGE-MRI 衍生的 LA-SRM 参数之间存在多重中等线性相关性，相关指数 (r(2)) 为 0.194-0.385。LGE-MRI 测量的 LA-SRM 显示与风湿性瓣膜疾病和持续性 AF 患者的 LA 病理学具有中等程度的一致性。
The aim of this study was to provide a histopathological validation of cardiac late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) for the assessment of left atrial (LA) substrate remodeling (SRM) in patients with rheumatic mitral valve disease and persistent atrial fibrillation (AF).Adult patients with rheumatic mitral valve disease and persistent AF undergoing open-heart surgery for mitral valve replacement were enrolled. Both two-dimensional (2D) sections and 3-dimensional (3D) full-volume LGE-MRI with different signal intensities were performed preoperatively to determine the extent of LA-SRM. Tissue samples were obtained intraoperatively from the LA roof and posterior lateral wall for pathological validation with Masson trichrome staining and immunostaining for collagen type I/III deposition. A linear regression model was used to determine the relationship between MRI-derived LA-SRM parameters and pathological results.Between February 2013 and March 2014, we successfully acquired LA tissue samples from 22 patients (13 men), with a mean age of 47 ± 8 years. All patients had rheumatic mitral valve stenosis, with a mean effective orifice area of 0.9 ± 0.2 cm(2) on echocardiography and a mean LA volume of 235 ± 85 mL on 3D-MRI. Multiple moderate linear associations were noted between the pathological results and LGE-MRI-derived LA-SRM parameters, with correlation indices (r(2)) of 0.194-0.385.LA-SRM measured by LGE-MRI showed moderate agreement with LA pathology in patients with rheumatic valve disease and persistent AF.