心脏磁共振特征追踪技术在单纯性肥胖患者心室功能评价中的价值

Value of cardiac magnetic resonance feature tracking in the evaluation of ventricular function in uncomplicated obesity subjects

目的探讨心脏磁共振特征追踪(cardiac magnetic resonance feature tracking,CMR-FT)技术在单纯性肥胖患者左、右心室功能评价中的价值。材料与方法对35例单纯性肥胖患者及性别、年龄匹配的35例健康对照者进行心脏磁共振电影成像,利用CVI 42软件测量左、右心室常规心功能参数、心肌应变参数,包括周向(circumferential)、径向(radial)及纵向(longitudinal)的峰值应变(peak strain,分别为PCS、PRS、PLS)、峰值舒张期应变率(peak diastolic strain rate,分别为PCSR-D、PRSR-D、PLSR-D)、峰值收缩期应变率(peak systolic strain rate,分别为PCSR-S、PRSR-S、PLSR-S),以及心外膜脂肪组织(epicardial adipose tissue,EAT)面积。两组间的比较采用独立样本t检验或Mann-Whitney U检验,相关性分析采用Spearman秩相关分析。P<0.05为差异具有统计学意义。结果与健康对照者相比,肥胖患者左、右心室EDV、ESV、LVmass、LVmassi及EAT面积明显增加(P均<0.05),两组左、右心室EDVi、ESVi和EF无明显差异(P均>0.05)。肥胖组左、右心室整体PRS、PCS、PRSR-S、PRSR-D、PCSR-D、PLSR-D及左心室整体PLS、PLSR-S较对照组明显降低(P均<0.05)。左、右心室EDV、ESV及LVmass与BMI、EAT面积呈显著正相关(P均<0.001),左、右心室整体PRS、PCS、PRSR-S、PRSR-D、PCSR-D、PLSR-D及左心室整体PLS、PLSR-S与BMI呈负相关(P均<0.05),左、右心室整体PCS、PLSR-S、PRSR-D、PCSR-D及左心室整体PRS、PLS、PRSR-S、PLSR-D与EAT面积呈负相关(P均<0.05)。结论单纯性肥胖患者左、右心室结构及亚临床功能的改变与BMI和EAT面积有关,CMR-FT技术可以评价单纯性肥胖患者早期心室运动功能的改变。

Objective:To explore the value of cardiac magnetic resonance feature tracking(CMR-FT)in the evaluation of left and right ventricular function in uncomplicated obesity subjects.Materials and Methods:Cardiac magnetic resonance cine imaging was performed in 35 uncomplicated obesity subjects and 35 sex-and age-matched healthy volunteers.The CVI 42 software was used to measure left and ventricular routine cardiac function and myocardial strain parameters,as well as epicardial adipose tissue(EAT)area.The strain parameters,including circumferential,radial and longitudinal peak strain(PCS,PRS,PLS,respectively),peak diastolic strain rate(PCSR-D,PRSR-D,PLSR-D,respectively),peak systolic strain rate(PCSR-S,PRSR-S,PLSR-S,respectively),were measured.Student's t test or Mann-Whitney U test was applied for comparison between the two groups,and Spearman rank correlation analysis was used for correlation analysis.P<0.05 were considered statistically significant.Results:Compared with the control group,the uncomplicated obesity subjects had higher left and right ventricular EDV,ESV,LVmass,LVmassi and EAT area(all P<0.05),but there was no significant difference in EDVi,ESVi and EF between the two groups.Meanwhile,the left and right ventricular global PRS,PCS,PRSR-S,PRSR-D,PCSR-D,PLSR-D and the left ventricular global PLS and PLSR-S were significantly decreased in obese group(all P<0.05).The left and right ventricular EDV,ESV and LVmass were positively correlated with BMI and EAT area(all P<0.001).The left and right ventricular global PRS,PCS,PRSR-S,PRSR-D,PCSR-D,PLSR-D and the left ventricular global PLS,PLSR-S were negatively correlated with BMI(all P<0.05).The left and right ventricular global PCS,PLSR-S,PRSR-D,PCSR-D and the left ventricular PRS,PLS,PRSR-S,PLSR-D and were negatively correlated with EAT area(all P<0.05).Conclusions:The changes of left and right ventricular structure and subclinical function in uncomplicated obesity subjects were associated with BMI and EAT area.CMR-FT can evaluate the early changes of ventricular myocardial function in uncomplicated obesity subjects.