心脏T1映射可以预测大动脉吐手术后LV功能障碍的风险
Martin Sinn1, Johannes Petersen2, Alexander Lenz1
1Department of Diagnostic and Interventional Radiology, University Hospital Eppendorf, Hamburg, Germany.
Frontiers in cardiovascular medicine
|July 10, 2023
概括
手术前的T1原生映射可以识别患有主动脉反的患者,在主动脉手术后面临左心室功能障碍的风险. 这种心脏MRI技术有助于预测术后结果,并优化手术时间.
科学领域:
- 心血管成像 - 心血管成像
- 心脏磁力共振成像 (MRI)
- 心肌纤维化检测 检测心肌纤维化
背景情况:
- 大动脉反 (AR) 可能导致左心室 (LV) 功能障碍.
- 对接受大动脉门手术的AR患者来说,评估术后LV功能障碍的术前风险至关重要.
- 心肌纤维化是LV功能障碍的一个关键因素.
研究的目的:
- 评估心脏T1映射用于检测心肌纤维化.
- 评估其在手术前识别AR患者的风险,以评估手术后早期LV功能障碍的能力.
- 为了确定T1映射是否可以指导外科手术时间.
主要方法:
- 1.5特斯拉心脏MRI与原生和后对比T1映射在手术前在40名AR患者中进行.
- 序列心声学评估了手术前和后 (8±5天) 的LV功能.
- 接收器操作特征 (ROC) 分析评估了T1映射在预测LV射出分数下降的准确性.
主要成果:
- 在手术后LVEF (1071±67毫秒) 降低的患者和保存LVEF (1019±33毫秒) (p=0.001) 的患者中,原生T1显著更高.
- 本地T1映射实现了0.820的曲线下的面积 (AUC),以区分保存和减少的LVEF.
- 截止值为1053毫秒显示70%的灵敏度和84%的特异性预测术后LV功能障碍.
结论:
- 在AR患者中,术前原生T1升高与动脉膜手术后静脉膜功能障碍的风险增加有关.
- 原生T1映射显示了优化手术时间以预防早期术后LV功能障碍的前景.
- 心脏T1映射是AR患者风险分层的一个有价值的工具.
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