慢性血栓栓塞性肺动脉高压患者心室血池T2 Map特征及意义

Characteristics and Diagnostic Value of Ventricular Blood Pool T2 Map in Chronic Thromboembolic Pulmonary Hypertension

目的 比较慢性血栓栓塞性肺动脉高压(CTEPH)患者与健康人群右心室与左心室血池的T2 map特征,探讨T2 mapping技术在评价CTEPH中的意义。资料与方法 前瞻性纳入2020年1月—2022年1月中日友好医院确诊的42例CTEPH患者和42例健康人(对照组)。CTEPH患者均行心脏磁共振和右心漂浮导管检查,对照组行心脏磁共振检查。在心脏磁共振中行舒张期四腔心层面T2 mapping成像。比较CTEPH组与对照组右心室血池与左心室血池T2比值(RVT2/LVT2),分析CTEPH组RVT2/LVT2与右心漂浮导管测定血流动力学参数的关系。结果 CTEPH组RVT2/LVT2较对照组显著减低,差异有统计学意义(0.74±0.16比0.86±0.12;t=3.673,P<0.001);CTEPH组RVT2/LVT2与肺血管阻力呈负相关(r=0.534,P<0.001),与心指数、右心房血氧饱和度、右心室血氧饱和度、肺动脉血氧饱和度呈正相关(r=0.600、0.603、0.648、0.582,P<0.001)。结论CTEPH患者心室血池RVT2/LVT2比值与右心血氧饱和度呈正相关、与肺血管阻力呈负相关;心室血池T2 mapping可能为无创评估CTEPH血流动力学提供重要信息。

Purpose To observe the right ventricle and left ventricle blood pool T2 map in chronic thromboembolic pulmonary hypertension(CTEPH)and healthy controls,and to analyze the value of T2 mapping technique in evaluating CTEPH.Materials and Methods A total of 42 patients with CTEPH and 42 healthy volunteers had been prospectively recruited from January 2020 to January 2022 in China-Japan Friendship Hospital.All CTEPH patients underwent cardiac magnetic resonance with T2 mapping and right heart catheterization.Cardiac magnetic resonance was performed on healthy controls.Diastolic T2 mapping was performed in cardiac magnetic resonance,and then the ratio of right ventricular to left ventricular T2 values(RVT2/LVT2)between the CTEPH group and the healthy group was calculated and compared.Meanwhile,the correlation between RVT2/LVT2 and hemodynamic parameters in the CTEPH group was analyzed.Results RVT2/LVT2 in the CTEPH group was significantly lower than that in the healthy group(0.74±0.16 vs.0.86±0.12;t=3.673,P<0.001).RVT2/LVT2 in CTEPH group was negatively correlated with pulmonary vascular resistance(r=-0.534,P<0.001);while it was positively correlated with cardiac index,right atrium oxygen saturation,right ventricle oxygen saturation and pulmonary arteries oxygen saturation(r=0.600,0.603,0.648,0.582,P<0.001).Conclusion RVT2/LVT2 in the CTEPH group is positively correlated with right cardiac oxygen saturation and negatively correlated with pulmonary vascular resistance.T2 mapping may be a noninvasive evaluation of hemodynamics in CTEPH.