Reproducibility of peak filling and peak emptying rate determined by cardiovascular magnetic resonance imaging for assessment of biventricular systolic and diastolic dysfunction in patients with pulmonary arterial hypertension
Reproducibility of peak filling and peak emptying rate determined by cardiovascular magnetic resonance imaging for assessment of biventricular systolic and diastolic dysfunction in patients with pulmonary arterial hypertension
复制标题
DOI：
10.1007/s10554-017-1281-1
复制
发表时间：
2018-05-01
影响因子：
2.1
通讯作者：
Carlsen, Jorn
中科院分区：
文献类型：
--
作者：
Goransson, Christoffer;Vejlstrup, Niels;Carlsen, Jorn
右心室（RV）和左心室（LV）舒张僵硬度可能是肺动脉高压（PAH）疾病进展的独立因素。本研究的目的是评估PAH患者RV和LV的峰值排空率（PER）和舒张早期峰值充盈率（PFR）的重现性，并研究其与每搏输出量（SV）的关系。对10名PAH患者和10名健康对照者进行了每周三次重复的20次（共60次）心血管磁共振（CMR）扫描。在整个心动周期内测量RV和LV容积。PER和PFR计算为RV和LV中时间-容积关系的一阶导数，并索引为体表面积。在一个混合模型中研究了繁殖率及其与SV的关系。右心室（PAH = 170 mL/m2/s，对照= 236 mL/m2/s [p < 0.01]）和左心室（PAH = 209 mL/m2/s，对照= 311 mL/m2/s [p < 0.01]）中PAH的PFR较低。患者和对照组的PER无显著差异。PER和PFR的繁殖率较高。以PFR正常化为目标的试验需要总样本量< 20。两个心室的PER和PFR与每搏输出量密切相关（所有四个：p < 0.01）。双心室舒张功能障碍与每搏输出量密切相关，CMR可以以高重现性对其进行量化，从而使针对舒张功能障碍的治疗试验能够实现小样本量，以提高生存率。
Right ventricular (RV) and left ventricular (LV) diastolic stiffness may be independent contributors to disease progression in pulmonary arterial hypertension (PAH). The aims of this study are to assess reproducibility of peak emptying rate (PER) and early diastolic peak filling rate (PFR) for both the RV and the LV in PAH and study their relationship to stroke volume (SV). Triple weekly repetition of 20 (totalling 60) cardiovascular magnetic resonance (CMR) scans, were done on 10 patients with PAH and 10 healthy controls. RV and LV volumes were measured over the full cardiac cycle. PER and PFR were calculated as the first derivative of the time-volume relationship in both the RV and the LV and indexed to body surface area. Reproducibility and the relation to SV were studied in a mixed model. PFR was lower in PAH in both the RV (PAH = 170 mL/m(2)/s, controls = 236 mL/m(2)/s [p < 0.01]) and in the LV (PAH = 209 mL/m(2)/s, controls = 311 mL/m(2)/s [p < 0.01]). PERs were not significantly different between patients and controls. Reproducibility of PER and PFR was high. A trial targeting normalization of PFR requires a total sample size of < 20. PER and PFR in both ventricles were strongly associated with stroke volume (all four: p < 0.01). Biventricular diastolic dysfunctions are strongly associated with stroke volume, and CMR can quantify them with high reproducibility, enabling small sample sizes for trials of therapies targeting diastolic dysfunction to increase survival.