MRI-based multiparametric strain analysis predicts contractile recovery after aortic valve replacement for aortic insufficiency.
MRI-based multiparametric strain analysis predicts contractile recovery after aortic valve replacement for aortic insufficiency.
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DOI：
10.1111/j.1540-8191.2012.01477.x
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发表时间：
2012-07
影响因子：
1.6
通讯作者：
Pasque MK
中科院分区：
文献类型：
--
作者：
Brady BD;Knutsen AK;Ma N;Gardner R;Taggar AK;Cupps BP;Kouchoukos NT;Pasque MK
主动脉瓣置换术（AVR）的慢性主动脉瓣关闭不全（AI）患者转诊指南建议，手术可延迟至出现症状或左心室（LV）收缩功能降低。AVR治疗慢性AI后LV收缩功能降低的频繁发生表明需要新的收缩指标用于外科转诊。在16例慢性AI患者中，分析了AVR前和AVR后21.5 ± 13.8个月的心脏MRI标记图像，以计算LV收缩应变。获得72个LV区域中每个区域的三个应变参数的平均测量值，使用正常人应变数据库（n=63）进行标准化，并组合成复合指数（多参数应变z评分[MSZ]），表示与正常区域平均值的标准差。术前整体MSZ（72个区域平均值）与AVR后整体MSZ相关（R2 = 0.825，p <0.001）。术前整体MSZ还可预测受损区域的改善（来自14名AI患者的N=271个区域，R2 = 0.392，p <0.001）。术前基于MRI的左心室射血分数（LVEF）也具有预测性（r = 0.410，p <0.001）。尽管总体术前MSZ与损伤区域改善的相关性显著高于术前LVEF（p <0.001），但两种测量方法表达了相同的现象。术前基于MRI的整体多参数应变预测术后整体应变，以及收缩功能受损区域（n=72/LV）的改善。整体收缩功能与局部受损收缩功能的改善有重要相关性，可能反映了总AI容量超负荷负荷（AI的严重程度/持续时间）。
Guidelines for referral of chronic aortic insufficiency (AI) patients for aortic valve replacement (AVR) suggest that surgery can be delayed until symptoms or reduction in left ventricular (LV) contractile function occur. The frequent occurrence of reduced LV contractile function after AVR for chronic AI suggests that new contractile metrics for surgical referral are needed. In 16 chronic AI patients, cardiac MRI tagged images were analyzed before and 21.5 ± 13.8 months after AVR to calculate LV systolic strain. Average measurements of three strain parameters were obtained for each of 72 LV regions, normalized using a normal human strain database (n=63), and combined into a composite index (multi-parametric strain z score [MSZ]) representing standard deviation from the normal regional average. Preoperative global MSZ (72-region average) correlated with post-AVR global MSZ (R2 = .825, p < .001). Preoperative global MSZ also predicts improvement of impaired regions (N=271 regions from 14 AI patients, R2 = .392, p < .001). Preoperative MRI-based left ventricular ejection fraction (LVEF) is also predictive (r = .410, p < .001). Although global preoperative MSZ had a significantly higher correlation than preoperative LVEF with improvement of injured regions (p < .001), both measures convey the same phenomenon. Global preoperative MRI-based multi-parametric strain predicts global strain postoperatively, as well as improvement of regions (n=72/LV) with impaired contractile function. Global contractile function is an important correlate with improvement in regionally impaired contractile function, perhaps reflecting total AI volume-overload burden (severity/duration of AI).
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影响因子：
--
作者：
Cupps BP;Taggar AK;Reynolds LM;Lawton JS;Pasque MK
通讯作者：
Pasque MK
影响因子：
19.7
作者：
AXEL, L;DOUGHERTY, L
通讯作者：
DOUGHERTY, L
影响因子：
4.6
作者：
Cupps, Brian P.;Bree, Douglas R.;Pasque, Michael K.
通讯作者：
Pasque, Michael K.
影响因子：
37.8
作者：
FIORETTI, P;ROELANDT, J;HUGENHOLTZ, PG
通讯作者：
HUGENHOLTZ, PG
影响因子：
37.8
作者：
Chaliki, HP;Mohty, D;Enriquez-Sarano, M
通讯作者：
Enriquez-Sarano, M