基于磁共振心肌特征追踪成像评估扩张型心肌病左心室心肌应变力的研究

Study of magnetic resonance myocardial feature tracking imaging in assessing left ventricular myocardial strain in dilated cardiomyopathy

目的基于磁共振心肌特征追踪成像(MR-FT)评估扩张型心肌病(DCM)左心室心肌应变力。方法选取衢州市中医医院2019年6月至2020年10月收治的65例DCM患者为DCM组,同期在同院体检的50名健康志愿者为对照组。两组对象均行MR-FT检查,比较左心室心功能参数[包括左心室射血分数(LVEF)、收缩末期容积、舒张末期容积、每搏出量、排出量、左心指数]和心肌应变力参数[全局径向峰值应变(GPRS)、全局纵向峰值应变(GPLS)、全局周向峰值应变(GPCS)],分析DCM患者心肌应变力参数与心功能参数的相关性。结果DCM组患者收缩末期容积、舒张末期容积及GPCS、GPLS均明显高于对照组,LVEF、每搏出量、排出量、左心指数及GPRS均明显低于对照组,差异均有统计学意义(均P<0.05)。DCM患者GPRS与LVEF、每搏出量、排出量、左心指数均呈正相关(均P<0.05),与收缩末期容积、舒张末期容积均呈负相关(均P<0.05);GPCS、GPLS与LVEF、每搏出量、排出量、左心指数均呈负相关(均P<0.05),与收缩末期容积、舒张末期容积均呈正相关(均P<0.05)。结论MR-FT能定量评估DCM左心室心肌应变力;且左心室心肌应变力参数与心功能参数呈一定的相关性,在一定程度上反映心功能损伤程度。

Objective To investigate the value of magnetic resonance myocardial feature tracking imaging(MR-FT in assessing left ventricular myocardial strain in dilated cardiomyopathy(DCM).Methods A total of 65 DCM patients admitted from June 2019 to October 2020 in Quzhou Muniapal Hospital of Traditional Chinese Medicine were selected as the DCM group,and 50 healthy individuals who received physical examinations during the same period were selected as the control group.All the subjects were examined by MR-FT imaging technology.The association between left ventricular cardiac function parameters[including left ventricular ejection fraction(LVEF),end-systolic volume,end-diastolic volume,stroke volume,cardiac index,left ventricular index]and myocardial strain parameters[global peak radial strain(GPRS),global peak long strain(GPLS)and global peak circumferential strain(GPCS)]were assessed.The clinical data,cardiac function parameters and myocardial strain parameters of the two groups were compared,and the relationship between myocardial strain parameters and cardiac function parameters of DCM patients was analyzed.Results The end-systolic volume,end-diastolic volume,GPCS and GPLS of the DCM group were significantly higher than those in the control group(all P<0.05),while LVEF,stroke volume,cardiac output,cardiac index and GPRS in DCM group were significantly lower than those in the control group(all P<0.05).In DCM patients,GPRS was positively correlated with LVEF,stroke volume,cardiac output and cardiac index(all P<0.05),and negatively correlated with LVESV and LVEDV(all P<0.05).GPCS and GPLS were negatively correlated with LVEF,stroke volume,cardiac output and cardiac index(all P<0.05),and positively correlated with LVESV and LVEDV(all P<0.05).Conclusion MR-FT can quantitatively evaluate the left ventricular myocardial strain capacity in DCM.The myocardial strain parameters were correlated with the parameters of cardiac function,reflecting the degree of cardiac function injury to a certain extent.