摘要
目的探讨射血分数正常的肥厚型心肌病(HCM)患者心肌T1和T2值与健康人的差异,进一步认知HCM患者心肌组织特征在功能异常前的改变。方法20例健康志愿者和34例左室射血分数正常的HCM患者纳入研究。所有受试者使用飞利浦Achieva 3.0 T TX多源发射磁共振仪进行心脏磁共振检查,扫描序列包括心脏磁共振电影成像、Native T1-mapping和T2-mapping。以舒张末期壁厚(EDWT)为基础,将HCM患者的心肌节段分为正常心肌节段(无HCM家族史,EDWT<15 mm;有HCM家族史,EDWT<13 mm)、肥厚心肌节段(无HCM家族史,EDWT≥15 mm;有HCM家族史,EDWT≥13 mm),与健康对照组进行比较,并进一步行组间比较。结果与健康对照组相比,HCM患者左室舒张末期容积、左室收缩末期容积和左室射血分数均未见统计学差异(P>0.05),但HCM患者肥厚节段与非肥厚节段的T1和T2值均升高;与非肥厚节段相比,肥厚节段T1和T2值均增加,室壁增厚率明显下降(P均<0.05)。结论心脏磁共振组织特征成像参数T1和T2值可早于心功能参数发现HCM异常;此外,即便心肌厚度正常,T1和T2值均较正常人增高,这提示组织特征的改变先于HCM的形态和功能重构,因此T1和T2值的测量可为HCM患者早期心肌的改变提供价值。
Objective To investigate the differences between T1 and T2 values of myocardium in patients with hypertrophic cardiomyopathy(HCM)with normal ejection fraction and healthy people,so as to further understand the changes of myocardial tissue characteristics in patients with HCM before functional abnormalities.Methods Twenty healthy volunteers and 34 HCM patients with normal left ventricular ejection fraction(LVEF)were included in the study.All subjects were underwent cardiac magnetic resonance(CMR)by Philips Achieva 3.0 T TX multi-source emission MRI.The scanning sequences included cine,native T1 mapping and T2 mapping.On the basis of end-diastolic wall thickness(EDWT),the myocardial segments of HCM patients were divided into normal segments(no family history of HCM,EDWT<15 mm;family history of HCM,EDWT<13 mm)and hypertrophic segments(no family history of HCM,EDWT≥15 mm;family history of HCM,EDWT≥13 mm),which were compared with healthy controls and further compared between groups.Results Compared with the healthy control group,there were no statistically significant differences in left ventricular end-diastolic volume,left ventricular end-systolic volume and LVEF(P>0.05);however,the T1 and T2 values of hypertrophic and non-hypertrophic segments were increased in HCM patients.Compared with non-hypertrophic segment,the T1 and T2 values of hypertrophic segment increased,and the thickening rate of ventricular wall decreased significantly(P<0.05).Conclusion T1 and T2 of CMR tissue imaging parameters can detect HCM abnormalities before cardiac function parameters.In addition,even if the myocardial thickness was normal,the values of T1 and T2 were higher than those of normal people,suggesting that the change of tissue characteristics precedes the morphological and functional remodeling of HCM.Therefore,the measurement of T1 and T2 values can provide value for the early myocardial changes of HCM patients.
作者
周小龙
赵晓莹
赵新湘
ZHOU Xiaolong;ZHAO Xiaoying;ZHAO Xinxiang(Department of Radiology,The Second Affiliated Hospital of Kunming Medical University,Kunming 650000,Yunnan,China)
出处
《心血管病学进展》
2021年第9期845-848,共4页
Advances in Cardiovascular Diseases
基金
云南省科技厅联合专项重点项目(2017FE468-178)
云南省中青年学术技术带头人培养项目(2015HB068)
云南省卫生和计划生育委员会医学学科带头人培养项目(D-201646)。
关键词
心肌病
肥厚型
心脏磁共振
T1
T2
Cardiomyopathy
Hypertrophic type
Cardiac magnetic resonance
T1
T2
作者简介
通信作者:赵新湘,E-mail:zhaoxinxiang06@126.com。
