Quantification of Biventricular Strains in Heart Failure With Preserved Ejection Fraction Patient Using Hyperelastic Warping Method.
Quantification of Biventricular Strains in Heart Failure With Preserved Ejection Fraction Patient Using Hyperelastic Warping Method.
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DOI：
10.3389/fphys.2018.01295
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发表时间：
2018
影响因子：
4
通讯作者：
Zhong L
中科院分区：
文献类型：
--
作者：
Zou H;Xi C;Zhao X;Koh AS;Gao F;Su Y;Tan RS;Allen J;Lee LC;Genet M;Zhong L
心力衰竭（HF）给社会和个人带来了重大的全球医疗保健负担。约50%的HF患者具有保留射血分数（HFpEF）。更复杂和全面的测量集中成像的多个应变组件可能有助于诊断和阐明这种疾病。在这里，我们描述了一种半自动超弹性翘曲方法的发展，用于快速全面评估双心室周向，纵向和径向应变，这是生理上有意义的和可重复的。我们招募并对30名受试者进行了心脏磁共振（CMR）成像[10名HFpEF，10名HF伴射血分数降低患者（HFrEF）和10名健康对照]。在每个受试者中，从CMR图像重建包括左心室（LV）、右心室（RV）和间隔的三维心脏模型。采用超弹性变形方法将分割后的模型与靶图像进行对比，得到双心室周向、纵向和径向应变-时间曲线。在这项研究中，然后测量和分析峰值收缩应变。双心室收缩期峰值应变的观察者内和观察者间重现性极好，所有ICC> 0.92。左心室收缩期峰值周向、纵向和径向应变分别表现出从健康对照→HFpEF→HFrEF的幅度进行性降低：对照（-15.5 ± 1.90，-15.6 ± 2.06，41.4 ± 12.2%）; HFpEF（-9.37 ± 3.23，-11.3 ± 1.76，22.8 ± 13.1%）; HFrEF（-4.75 ± 2.74，-7.55 ± 1.75，10.8 ± 4.61%）。观察到RV峰值收缩期周向、纵向和径向应变的幅度类似进行性降低：对照组（-9.91 ± 2.25，-14.5 ± 2.63，26.8 ± 7.16%）; HFpEF（-7.38 ± 3.17，-12.0 ± 2.45，21.5 ± 10.0%）; HFrEF（-5.92 ± 3.13，-8.63 ± 2.79，15.2 ± 6.33%）。此外，从健康对照组到HFrEF对照组，室间隔收缩期峰值周向、纵向和径向应变值逐渐降低：（-7.11 ± 1.81，16.3 ± 3.23，18.5 ± 8.64%）; HFpEF（-6.11 ± 3.98，-13.4 ± 3.02，12.5 ± 6.38%）; HFrEF（-1.42 ± 1.36，-8.99 ± 2.96，3.35 ± 2.95%）。ROC分析表明，左室收缩期峰值周向应变是区分HFpEF与健康对照组的最敏感指标。我们的研究结果表明，超弹性翘曲方法与CMR衍生的应变可能会揭示HF双心室力学的微妙损害，特别是尽管在HFpEF的心室射血分数“正常”。
Heart failure (HF) imposes a major global health care burden on society and suffering on the individual. About 50% of HF patients have preserved ejection fraction (HFpEF). More intricate and comprehensive measurement-focused imaging of multiple strain components may aid in the diagnosis and elucidation of this disease. Here, we describe the development of a semi-automated hyperelastic warping method for rapid comprehensive assessment of biventricular circumferential, longitudinal, and radial strains that is physiological meaningful and reproducible. We recruited and performed cardiac magnetic resonance (CMR) imaging on 30 subjects [10 HFpEF, 10 HF with reduced ejection fraction patients (HFrEF) and 10 healthy controls]. In each subject, a three-dimensional heart model including left ventricle (LV), right ventricle (RV), and septum was reconstructed from CMR images. The hyperelastic warping method was used to reference the segmented model with the target images and biventricular circumferential, longitudinal, and radial strain–time curves were obtained. The peak systolic strains are then measured and analyzed in this study. Intra- and inter-observer reproducibility of the biventricular peak systolic strains was excellent with all ICCs > 0.92. LV peak systolic circumferential, longitudinal, and radial strain, respectively, exhibited a progressive decrease in magnitude from healthy control→HFpEF→HFrEF: control (-15.5 ± 1.90, -15.6 ± 2.06, 41.4 ± 12.2%); HFpEF (-9.37 ± 3.23, -11.3 ± 1.76, 22.8 ± 13.1%); HFrEF (-4.75 ± 2.74, -7.55 ± 1.75, 10.8 ± 4.61%). A similar progressive decrease in magnitude was observed for RV peak systolic circumferential, longitudinal and radial strain: control (-9.91 ± 2.25, -14.5 ± 2.63, 26.8 ± 7.16%); HFpEF (-7.38 ± 3.17, -12.0 ± 2.45, 21.5 ± 10.0%); HFrEF (-5.92 ± 3.13, -8.63 ± 2.79, 15.2 ± 6.33%). Furthermore, septum peak systolic circumferential, longitudinal, and radial strain magnitude decreased gradually from healthy control to HFrEF: control (-7.11 ± 1.81, 16.3 ± 3.23, 18.5 ± 8.64%); HFpEF (-6.11 ± 3.98, -13.4 ± 3.02, 12.5 ± 6.38%); HFrEF (-1.42 ± 1.36, -8.99 ± 2.96, 3.35 ± 2.95%). The ROC analysis indicated LV peak systolic circumferential strain to be the most sensitive marker for differentiating HFpEF from healthy controls. Our results suggest that the hyperelastic warping method with the CMR-derived strains may reveal subtle impairment in HF biventricular mechanics, in particular despite a “normal” ventricular ejection fraction in HFpEF.
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影响因子：
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作者：
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