多模式成像评估,以检测急性心肌炎患者的微妙右心室干涉和保存的左心室射出小部分
Michela Bonanni1,2, Gianmarco Angelini1,3, Laura Anna Leo1
1Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Via Tesserete, 48, 6900 Lugano, Switzerland.
Journal of clinical medicine
|July 14, 2023
概括
心血管磁共振特征追踪 (CMR-FT) 可以检测急性心肌炎 (MY) 中的亚临床右心室 (RV) 参与. 患有下部和侧部段 (IL-MY) 心肌炎的患者在CMR-FT.上显示了减少的RV自由壁应变 (RV-FWS).
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 心血管疾病 心血管疾病
背景情况:
- 在急性心肌炎 (MY) 中评估右心室 (RV) 功能具有挑战性,使用标准的2D横心心回声学 (TTE) 和心血管磁共振 (CMR).
- 肌心炎可以影响RV功能,但其评估需要先进的成像技术.
- 常规成像方法可能会忽略临床下RV参与.
研究的目的:
- 确定CMR特征跟踪 (FT) 的增量诊断值,用于评估急性心肌炎患者的VR参与.
- 使用CMR-FT评估RV-FWS,并将其与心肌损伤的程度相关联.
- 为了研究心肌炎患者的亚临床RV功能障碍与保存的左心室喷射分数.
主要方法:
- 54名患有急性心肌炎和保存的左心室喷射分数的患者接受了CMR,包括T2加权的图像对和晚期加多增强 (LGE) 进行痕评估.
- 使用CMR特征跟踪 (CMR-FT) 来计算左心室全球纵向应变 (LV-GLS) 和RV自由壁应变 (RV-FWS).
- 患者被分为下部和侧部 (IL-MY) 参与 (n=34) 和 noIL-MY (n=20);包括一个没有心脏病的对照组 (n=20).
主要成果:
- 在任何心肌炎患者中,没有通过TTE或CMR (T2加权,LGE) 检测到任何可见的VR参与.
- 与对照组相比,心肌炎患者的LV-GLS显著降低 (中位数为-19.0%对比-21.0%,p=0.029).
- 总体而言,肌心炎患者和对照人群之间的RV-FWS没有差异 (中位数为-21.2%vs. -23.2%,p=0.201),但与IL-MY组相比,IL-MY组的RV-FWS明显较低 (中位数为-18.17%vs. -24.2%,p=0.004).
结论:
- CMR-FT可以确定急性心肌炎的亚临床RV参与,特别是在心肌下部和侧部损伤的患者中.
- 在CMR-FT上降低RV-FWS是RV功能障碍在特定心肌炎模式中的敏感标志物.
- 使用CMR-FT的RV变形分析为心肌炎患者提供了全面的功能评估.
相关概念视频
Imaging Studies for Cardiovascular System II:Types of Echocardiography
305
Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
305
Mitral Stenosis II: Clinical features and Diagnostic Tests
23
Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
23
Acute Coronary Syndrome III: Diagnostic Studies
10
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
10
Imaging Studies for Cardiovascular System IV: CMRI
64
Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...
64
Imaging Studies for Cardiovascular System I:Echocardiography
386
Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
386
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
38
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
38


