Automated quantitative assessment of cardiovascular magnetic resonance-derived atrioventricular junction velocities
Automated quantitative assessment of cardiovascular magnetic resonance-derived atrioventricular junction velocities
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DOI：
10.1152/ajpheart.00284.2015
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发表时间：
2015-12-01
影响因子：
4.8
通讯作者：
Zhong, Liang
中科院分区：
文献类型：
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作者：
Leng, Shuang;Zhao, Xiao-Dan;Zhong, Liang
房室交界区(AVJ)变形的评价在临床评价左心室收缩和舒张期功能中起着重要作用。本研究旨在与组织多普勒超声心动图(TDE)比较，证明心血管磁共振(CMR)定量评价AVJ血流速度的有效性和一致性。145例受试者包括21例健康志愿者、8例心力衰竭患者、17例肥厚型心肌病患者、52例心肌梗死患者和47例法洛四联症修复术患者，进行TDE和CMR扫描。用3个CMR切面追踪6个AVJ点。提取并分析舒张期峰值血流速度(SM1)、舒张期早期血流速度(Em)、舒张期晚期血流速度(Am)。所有由CMR获得的房室间隔和侧壁AVJ的速度与TDE测量结果有很好的相关性(Sm1：R=0.736；Em：Rw=0.835；Am：r=0.701；Em/Am：r=0.691；All p<；0.001)，并表现出极好的重复性[研究内：r=0.921-0.991，组内相关系数：0.918-0.991；研究间：r=0.900-0.970，ICC：0.887-0.957；All p<；0.001]。结合所有角度测量的三维AVJ运动的评估更好地区分正常和病变状态[曲线下面积(AUC)=0.918]，并为心衰患者机械不同步的诊断提供了进一步的见解(AUC=0.987)。这些结果表明，基于CMR的方法在量化AVJ变形方面是可行、准确和一致的，并随后在诊断收缩和舒张期心功能不全方面是可行的。
The assessment of atrioventricular junction (AVJ) deformation plays an important role in evaluating left ventricular systolic and diastolic function in clinical practice. This study aims to demonstrate the effectiveness and consistency of cardiovascular magnetic resonance (CMR) for quantitative assessment of AVJ velocity compared with tissue Doppler echocardiography (TDE). A group of 145 human subjects comprising 21 healthy volunteers, 8 patients with heart failure, 17 patients with hypertrophic cardiomyopathy, 52 patients with myocardial infarction, and 47 patients with repaired Tetralogy of Fallot were prospectively enrolled and underwent TDE and CMR scan. Six AVJ points were tracked with three CMR views. The peak systolic velocity (Sm1), diastolic velocity during early diastolic filling (Em), and late diastolic velocity during atrial contraction (Am) were extracted and analyzed. All CMR-derived septal and lateral AVJ velocities correlated well with TDE measurements (Sm1: r = 0.736; Em: r w= 0.835; Am: r = 0.701; Em/Am: r = 0.691; all p < 0.001) and demonstrated excellent reproducibility [intrastudy: r = 0.921-0.991, intraclass correlation coefficient (ICC): 0.918-0.991; interstudy: r = 0.900- 0.970, ICC: 0.887-0.957; all p < 0.001]. The evaluation of three-dimensional AVJ motion incorporating measurements from all views better differentiated normal and diseased states [area under the curve (AUC) = 0.918] and provided further insights into mechanical dyssynchrony diagnosis in HF patients (AUC = 0.987). These findings suggest that the CMR-based method is feasible, accurate, and consistent in quantifying the AVJ deformation, and subsequently in diagnosing systolic and diastolic cardiac dysfunction.