静脉内4D流心血管磁共振用于评估心力衰竭患者的心脏衰竭:一个试点研究
Chi Ting Kwan1, On Hang Samuel Ching1, Pui Min Yap1
1Department of Diagnostic Radiology, The University of Hong Kong, Pok Fu Lam, Hong Kong.
The international journal of cardiovascular imaging
|June 28, 2023
概括
通过保留喷射分数 (HFpEF) 诊断心力衰竭是一项挑战. 四维流动心血管磁共振 (4D流动CMR) 在使用左心室 (LV) 直流和残留体积指标区分HFpEF患者方面表现有前途.
科学领域:
- 心血管成像 - 心血管成像
- 心脏生理学 心脏生理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 通过保留喷射分数 (HFpEF) 诊断心力衰竭存在重大临床挑战.
- 目前对HFpEF的诊断方法可能是复杂的和侵入性的,需要改进的非侵入性技术.
- 心室内四维流 (4D流) 心血管磁共振 (CMR) 提供了对左心室 (LV) 血液动力学的详细评估.
研究的目的:
- 调查静脉内4D流CMR在区分HFpEF患者与没有HFpEF患者和健康对照患者的实用性.
- 评估特定的LV流量组件,包括直流,延迟喷射,保留的入流和残留体积,作为HFpEF的潜在生物标志物.
主要方法:
- 潜在的招募患者怀疑HFpEF和无症状对照.
- 使用欧洲心脏病学会 (ESC) 2021年标准确认HFpEF诊断;非HFpEF组包括不符合标准的个人.
- 获取和分析心室内4D流量CMR数据,以量化LV直接流量,延迟喷射,保留的流入和残留体积.
- 统计分析包括接收器操作特征 (ROC) 曲线分析,以评估诊断性能.
主要成果:
- 该研究包括63名受试者:25名HFpEF患者,22名非HFpEF患者和16名无症状对照.
- 来自4D流CMR的LV直流和残留体积显著区分了HFpEF患者与组合非HFpEF和对照组 (p < 0.001) 的HFpEF患者.
- 直接流量 (AUC 0.781) 和残留体积 (AUC 0.740) 在区分HFpEF患者与非HFpEF患者方面表现出最高的诊断准确性.
结论:
- 腹腔内4D流CMR衍生LV直流和残留体积显示潜在的非侵入性工具来区分HFpEF患者.
- 这些血液动力学参数可能有助于对HFpEF进行具有挑战性的诊断,从而有可能改善患者管理.
- 需要在更大的队列中进一步验证,以确定4D流CMR在HFpEF诊断中的临床实用性.
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