CT定量评估经导管主动脉瓣置换术前患者心肌应变的可行性研究被引量：1

Feasibility of CT quantitative evaluation for myocardial strain in patients before transcatheter aortic valve replacement

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摘要目的以心脏磁共振(CMR)为参考标准,探讨CT评估经导管主动脉瓣置换术(TAVR)术前患者心肌应变的可行性。方法回顾性收集2022年6至12月首都医科大学附属北京安贞医院行心脏CT检查的TAVR术前患者43例,采集心脏CT和CMR数据,测量心肌应变参数。将基于心脏CT的心功能和应变参数与CMR进行比较,包括LVEF、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、舒张期心肌质量(MASS)、心排血量、整体纵向应变峰值(GPLS)、整体周向应变峰值(GPCS)和整体径向应变峰值(GPRS)。结果基于心脏CT获得的LVEF、心排血量与CMR参数接近,差异无统计学意义(P>0.05),而基于心脏CT获得的LVEDV、LVESV、MASS明显高于CMR,GPLS、GPCS、GPRS绝对值明显低于CMR,差异有统计学意义(P<0.01)。Pear-son相关性分析显示,基于心脏CT的LVEF、LVEDV、LVESV、MASS、GPCS、GPRS与CMR参数呈较强正相关(r=0.908,r=0.917,r=0.947,r=0.954,r=0.856,r=0.864,P<0.01),而心排血量和GPLS呈中等正相关(r=0.763,r=0.656,P<0.01)。Bland-Altman分析显示,基于心脏CT获得的LVEF、心排血量、GPLS、GPCS、GPRS与CMR参数的偏差较小。结论心脏CT定量评估TAVR术前患者心功能与应变具有可行性,基于心脏CT的心功能参数与CMR参数一致性良好,而心肌应变参数相较于CMR偏低。 Objective To explore the feasibility of CT evaluation of myocardial strain in patients undergoing transcatheter aortic valve replacement(TAVR)with cardiac magnetic resonance(CMR)as the reference standard.Methods A retrospective study was conducted on 43 patients undergoing cardiac CT examination before TAVR in our hospital from June to December 2022.The cardiac CT and CMR data were collected,and myocardial strain parameters were measured.The cardiac function and strain parameters based on cardiac CT were compared with the parame-ters of CMR,including left ventricular ejection fraction(LVEF)left ventricular end-diastolic vol-ume(LVEDV),left ventricular end-systolic volume(LVESV),diastolic myocardial mass(MASS),cardiac output,global peak longitudinal strain(GPLS),global peak circumferential strain(GPCS)and global peak radial strain(GPRS).Results The values of LVEF and cardiac output derived from cardiac CT were close to those from CMR(P>0.05),while the values of LVEDV,LVESV and MASS from cardiac CT were significantly higher than those from CMR,and those of GPLS,GCPS and GRPS from cardiac CT were obviously lower than those from CMR(P<0.01).Pearson correlation analysis showed that the LVEF,LVEDV,LVESV,MASS,GCPS and GRPS derived from cardiac CT had strongly positive correlation with those from CMR(r=0.908,r=0.917,r=0.947,r=0.954,r=0.856,r=0.864,P<0.01),while the cardiac output and GPLS had a moderate positive correlation(r=0.763,r=0.656,P<0.01).Bland-Altman analysis showed that the LVEF,cardiac output,GPLS,GCPS and GRPS derived from cardiac CT had small biases with those from CMR.Conclusion Cardiac CT quantitative evaluation of cardiac function and strain is feasible in patients undergoing TAVR,and the cardiac function parameters of cardiac CT have good agreement with those from CMR,whde the myocardial strain parameters are lower than those from CMR.

作者张文涛周振高一峰王瑞徐磊 Zhang Wentao;Zhou Zhen;Gao Yifeng;Wang Rui;Xu Lei(Department of Radiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区首都医科大学附属北京安贞医院医学影像科张家口市第一医院放射医学科

出处《中华老年心脑血管病杂志》 CAS 北大核心 2023年第12期1245-1250,共6页 Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基金国家自然科学基金(U1908211,82271986) 首都卫生发展科研专项项目(2020-1-1052)。

关键词经导管主动脉瓣置换体层摄影术 X线计算机磁共振成像回顾性研究心肌心肌应变参数 transcatheter aortic valve replacement tomography,X-ray computed magnetic reso-nance imaging retrospective studies myocardium myocardial strain parameters

分类号 R654.2 [医药卫生—外科学]

作者简介通信作者:徐磊,Email:leixu2001@aliyun.com。