肺动脉高压患者左室心肌应变的MRI研究

MR Research of Left Ventricular Myocardial Strain in Patients with Pulmonary Hypertension

目的探讨形变配准算法(DRA)评价肺动脉高压(PH)患者左室心肌应变的可行性以及左室心肌应变参数与右心功能指标之间的关系。方法本研究共纳入30例PH患者以及19名健康志愿者,均进行心脏磁共振检查。将心脏电影图像导入Trufi Strain软件,测量受检者的整体及节段应变值。结果对照组、LVEF≥50%PH组、LVEF<50%PH组的Ell、Ecc、Err呈阶梯状下降趋势(P<0.05),RVEF≥40%PH组和对照组的左室应变值未见明显统计学差异。LVEF与Ell显著相关(r=-0.792,P<0.01);RVEF与Err显著相关(r=-0.764,P<0.01);RVEDVI与IVS-Ecc显著相关(r=0.768,P<0.01);mPAP与IVS-Ell、FW-Ecc、FW-Err相关(P<0.05)。结论DRA技术评价PH患者的左室心肌应变是可行的,LVEF保留的患者存在早期的左室收缩功能障碍,RVEF≥40%的PH患者的左室心肌应变未见明显异常,左室心肌应变参数与右心功能指标相关。

Objective To investigate the feasibility of deformation registration algorithm in evaluating left ventricular myocardial strain in patients with pulmonary hypertension(PH)and the relationship between left ventricular myocardial strain parameters and right heart function parameters.Methods A total of 30 PH patients and 19 healthy volunteers were enrolled in the study.All patients underwent cardiac magnetic resonance imaging.The cardiac cine images were imported into the Trufi Strain software to measure the global and regional strain.Results LVEF≥50%PH group,and LVEF<50%group showed a step-like downward trend(P<0.05).There was no significant difference in left ventricular strain between the RVEF≥40%PH group and the control group.LVEF was significantly correlated with Ell(r=-0.792,P<0.01);RVEF was significantly correlated with Err(r=-0.764,P<0.01);RVEDVI was significantly correlated with IVS-Ecc(r=0.768,P<0.01);mPAP was correlated with IVS-Ell,FW-Ecc,FW-Err(P<0.05).Conclusion It is feasible to evaluate the left ventricular myocardial strain mechanism in patients with pulmonary hypertension by DRA.Early left ventricular systolic dysfunction was found in patients with normal LVEF.LV strain was normal in patients with RVEF(>40%)PH.LV strain parameters were correlated with right ventricular function.