Three-dimensional biventricular strains in pulmonary arterial hypertension patients using hyperelastic warping.
Three-dimensional biventricular strains in pulmonary arterial hypertension patients using hyperelastic warping.
复制标题
使用超弹性扭曲测量肺动脉高压患者的三维双心室应变。
DOI：
10.1016/j.cmpb.2020.105345
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发表时间：
2020
影响因子：
6.1
通讯作者：
Zhong,Liang
中科院分区：
文献类型：
--
作者：
Zou,Hua;Leng,Shuang;Xi,Ce;Zhao,Xiaodan;Koh,AngelaS;Gao,Fei;Tan,JuLe;Tan,Ru-San;Allen,JohnC;Lee,LikChuan;Genet,Martin;Zhong,Liang
背景和目的双心室功能评估是肺动脉高压（PAH）临床治疗的重要组成部分。本研究旨在检查 PAH 患者与年龄和性别匹配的正常对照相比，通过模型到图像配准技术获得的双心室应变的效用。方法根据电影短轴和长轴心脏磁共振 (CMR) 图像重建三维 (3D) 模型，然后将其分为右心室 (RV)、左心室 (LV) 和隔膜。使用超弹性扭曲方法来记录整个心动周期的网格化双心室有限元模型，并获得相应的双心室周向、纵向和径向应变。结果观察者内和观察者间双心室应变的再现性非常好，所有组内相关系数均> 0.84。与对照组相比，PAH 患者的右心室、左心室和间隔的 3D 双心室纵向、周向和径向应变显着降低。接受者操作特征 (ROC) 分析表明，与二维应变和射血分数等传统参数相比，3D 双心室应变是心室功能障碍更好的早期标志物（右心室纵向应变的 ROC 曲线下面积 = 0.96）。结论我们的高度可重复的方法具有扩展 CMR 成像来表征 3D 双心室应变的潜力，最终导致对 PAH 中双心室力学的更深入了解。
Background and ObjectiveEvaluation of biventricular function is an essential component of clinical management in pulmonary arterial hypertension (PAH). This study aims to examine the utility of biventricular strains derived from a model-to-image registration technique in PAH patients in comparison to age- and gender-matched normal controls.MethodsA three-dimensional (3D) model was reconstructed from cine short- and long-axis cardiac magnetic resonance (CMR) images and subsequently partitioned into right ventricle (RV), left ventricle (LV) and septum. The hyperelastic warping method was used to register the meshed biventricular finite element model throughout the cardiac cycle and obtain the corresponding biventricular circumferential, longitudinal and radial strains.ResultsIntra- and inter-observer reproducibility of biventricular strains was excellent with all intra-class correlation coefficients > 0.84. 3D biventricular longitudinal, circumferential and radial strains for RV, LV and septum were significantly decreased in PAH patients compared with controls. Receiver operating characteristic (ROC) analysis showed that the 3D biventricular strains were better early markers (Area under the ROC curve = 0.96 for RV longitudinal strain) of ventricular dysfunction than conventional parameters such as two-dimensional strains and ejection fraction.ConclusionsOur highly reproducible methodology holds potential for extending CMR imaging to characterize 3D biventricular strains, eventually leading to deeper understanding of biventricular mechanics in PAH.