Cardiovascular magnetic resonance-assessed fast global longitudinal strain parameters add diagnostic and prognostic insights in right ventricular volume and pressure loading disease conditions.
Cardiovascular magnetic resonance-assessed fast global longitudinal strain parameters add diagnostic and prognostic insights in right ventricular volume and pressure loading disease conditions.
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DOI：
10.1186/s12968-021-00724-5
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发表时间：
2021-04-01
期刊：
影响因子：
--
通讯作者：
Zhong L
中科院分区：
文献类型：
--
作者：
Leng S;Tan RS;Guo J;Chai P;Zhang G;Teo L;Ruan W;Yeo TJ;Zhao X;Allen JC;Tan JL;Yip JW;Chen Y;Zhong L
心肌变形参数可提供对右室功能不全的更好认识。我们用一种快速、半自动的方法对法洛四联症修复术(RTOF)和肺动脉高压(PAH)患者的右室纵向心肌功能进行了量化，并探讨了其诊断和预后价值。这项研究纳入了150名患者(rTOF，n=375；PAH，n=75)和75名健康对照。在电影心血管磁共振(CMR)上，通过跟踪内、外侧三尖瓣附着点到右室心外膜心尖部的距离，获得右室参数：快速整体纵向应变(GLS)和收缩期应变率(GLSRs)、舒张期早期应变率(GLSRe)和舒张期晚期应变率(GLSRa)。RV FAST GLS与传统特征跟踪方法得到的应变值具有良好的一致性(偏差−为4.9%，误差限(± 2·标准差) ± 为4.3%)，具有更好的重复性和分析时间。与健康对照组相比，PAH组和rTOF组的平均RV空腹GLS降低(PAH <； rTOF <； 健康对照组：15.1RV± 4.9 <； 19.3 ± 2.4 <； 24.4 ± 3.0%，All P <； 0.001%)。在rTOF患者中，RV空腹GLS与代谢当量、最大耗氧量(PVO2)和运动心肺运动试验中达到的预计PVO2百分比显著相关。RV空腹GLS降低与rTOF运动负荷不足有关(曲线下面积 = 0.822，敏感性 = 72%，特异性 = 91%，截止= 19.3%)。在肺动脉高压患者中，RV FAST GLS减少与右室失代偿血流动力学相关(AUC = 0.717，敏感性 = 75%，特异性 = 58%，截止= 14.6%)和较高的临床恶化风险(AUC = 0.808，敏感性 = 79%，特异性 = 70 %，截止= 16.0%)。由CMR评估的定量RV快速应变和应变率参数可识别rTOF和PAH中的RV功能异常，并可预测这些患者的运动能力、RV失代偿和临床风险。试验登记处ClinicalTrials.gov：nct03217240在线版本包含补充材料，可在10.1186/s12968-021-321-5上查阅。
Parameters of myocardial deformation may provide improved insights into right ventricular (RV) dysfunction. We quantified RV longitudinal myocardial function using a fast, semi-automated method and investigated its diagnostic and prognostic values in patients with repaired tetralogy of Fallot (rTOF) and pulmonary arterial hypertension (PAH), who respectively exemplify patients with RV volume and pressure overload conditions. The study enrolled 150 patients (rTOF, n = 75; PAH, n = 75) and 75 healthy controls. RV parameters of interest were fast global longitudinal strain (GLS) and strain rates during systole (GLSRs), early diastole (GLSRe) and late diastole (GLSRa), obtained by tracking the distance from the medial and lateral tricuspid valve insertions to the RV epicardial apex on cine cardiovascular magnetic resonance (CMR). The RV fast GLS exhibited good agreement with strain values obtained by conventional feature tracking approach (bias − 4.9%, error limits (± 2·standard deviation) ± 4.3%) with fast GLS achieving greater reproducibility and requiring reduced analysis time. Mean RV fast GLS was reduced in PAH and rTOF groups compared to healthy controls (PAH < rTOF < healthy controls: 15.1 ± 4.9 < 19.3 ± 2.4 < 24.4 ± 3.0%, all P < 0.001 in pairwise comparisons). In rTOF patients, RV fast GLS was significantly associated with metabolic equivalents, peak oxygen consumption (PVO2) and percentage of predicted PVO2 achieved during cardiopulmonary exercise testing. Lower RV fast GLS was associated with subnormal exercise capacity in rTOF (area under the curve (AUC) = 0.822, sensitivity = 72%, specificity = 91%, cut-off = 19.3%). In PAH patients, reduced RV fast GLS was associated with RV decompensated hemodynamics (AUC = 0.717, sensitivity = 75%, specificity = 58%, cut-off = 14.6%) and higher risk of clinical worsening (AUC = 0.808, sensitivity = 79%, specificity = 70 %, cut-off = 16.0%). Quantitative RV fast strain and strain rate parameters assessed from CMR identify abnormalities of RV function in rTOF and PAH and are predictive of exercise capacity, RV decompensation and clinical risks in these patients. Trial registry Clinicaltrials.gov: NCT03217240 The online version contains supplementary material available at 10.1186/s12968-021-00724-5.
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影响因子：
2.6
作者：
Schuster, A.;Stahnke, V. -C.;Lotz, J.
通讯作者：
Lotz, J.
DOI：
10.1186/s12968-017-0380-4
发表时间：
2017-09-01
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
Bourfiss M;Vigneault DM;Aliyari Ghasebeh M;Murray B;James CA;Tichnell C;Mohamed Hoesein FA;Zimmerman SL;Kamel IR;Calkins H;Tandri H;Velthuis BK;Bluemke DA;Te Riele ASJM
通讯作者：
Te Riele ASJM
DOI：
10.1186/s12968-016-0258-x
发表时间：
2016-06-16
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
de Siqueira ME;Pozo E;Fernandes VR;Sengupta PP;Modesto K;Gupta SS;Barbeito-Caamaño C;Narula J;Fuster V;Caixeta A;Sanz J
通讯作者：
Sanz J
DOI：
10.1186/s12968-018-0496-1
发表时间：
2018-11-05
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
Leng S;Tan RS;Zhao X;Allen JC;Koh AS;Zhong L
通讯作者：
Zhong L
DOI：
10.1152/ajpheart.01376.2006
发表时间：
2007-07-01
影响因子：
4.8
作者：
Carlsson, Marcus;Ugander, Martin;Arheden, Hakan
通讯作者：
Arheden, Hakan