Magnetic resonance imaging-based multiparametric systolic strain analysis and regional contractile heterogeneity in patients with dilated cardiomyopathy.
Magnetic resonance imaging-based multiparametric systolic strain analysis and regional contractile heterogeneity in patients with dilated cardiomyopathy.
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DOI：
10.1016/j.healun.2008.12.018
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发表时间：
2009-04
期刊：
影响因子：
--
通讯作者：
Pasque MK
中科院分区：
文献类型：
--
作者：
Joseph S;Moazami N;Cupps BP;Howells A;Craddock H;Ewald G;Rogers J;Pasque MK
扩张型心肌病的心肌收缩应变模式被认为是不均匀的，但还没有研究基于MRI的多参数收缩应变分析。左心室（LV）三维（3D）多参数收缩应变分析对区域收缩性敏感，并且由组织标记网格线点位移的顺序磁共振成像（MRI）生成。对60名正常志愿者进行基于MRI的3D收缩期应变分析，以提供15，300个单独LV网格点处三个应变参数中每一个的正常平均值和标准差值。然后将每例扩张型心肌病患者（n = 10）的患者特异性多参数收缩期应变数据与正常应变数据库的3个单独应变组分进行逐点比较（n = 15，300个LV点）（每例患者45，900个数据库比较）。将得到的复合多参数Z评分值（与正常平均值的标准差）在患者特异性3D LV几何形状上进行彩色轮廓映射，以检测与扩张型心肌病相关的标准化区域收缩模式。根据心室水平（p = 0.001）和区域（p = 0.003），平均多参数应变Z评分值差异显著。心尖部Z评分显著低于基底部（p = 0.037）和中心室（p = 0.002），而前侧壁Z评分低于前间隔（p = 0.023）和后间隔（p = 0.028）。基于MRI的多参数收缩期应变分析表明，扩张型心肌病患者的心肌收缩期应变具有不均匀的区域分布，平均福尔斯几乎下降到正常值的两个标准差。
Myocardial systolic strain patterns in dilated cardiomyopathy are felt to be nonhomogeneous but have not been investigated with MRI-based multiparametric systolic strain analysis. Left ventricular (LV) three-dimensional (3D) multiparametric systolic strain analysis is sensitive to regional contractility and is generated from sequential magnetic resonance imaging (MRI) of tissue tagging gridline point displacements. Sixty normal human volunteers underwent MRI-based 3D systolic strain analysis to supply normal average and standard deviation values for each of three strain parameters at each of 15,300 individual LV grid points. Patient-specific multiparametric systolic strain data from each dilated cardiomyopathy patient (n = 10) were then subjected to a point-by-point comparison (n = 15,300 LV points) to the normal strain database for 3 individual strain components (45,900 database comparisons per patient). The resulting composite multiparametric Z-score values (standard deviation from normal average) were color contour mapped over patient-specific 3D LV geometry to detect the normalized regional contractile patterns associated with dilated cardiomyopathy. Average multiparametric strain Z-score values varied significantly according to ventricular level (p = 0.001) and region (p = 0.003). Apical Z-scores were significantly less than those in both the base (p = 0.037) and mid-ventricle (p = 0.002), while anterolateral wall Z-scores were less than those in the anteroseptal (p = 0.023) and posteroseptal walls (p = 0.028). MRI-based multiparametric systolic strain analysis suggests that myocardial systolic strain in patients with dilated cardiomyopathy has a heterogeneous regional distribution and on average falls almost two standard deviations from normal.
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