右心室应变分析在心律失常性右心室心肌病的增量诊断价值
Zhixiang Dong1, Xuan Ma1, Jiaxin Wang1
1Department of Magnetic Resonance Imaging, Fuwai Hospital, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China.
Journal of the American Heart Association
|December 29, 2023
概括
右心室应变分析,特别是全球纵向应变 (RV GLS),在与心血管磁共振 (CMR) 标准相结合时,显著改善了不律性RV心肌病 (ARVC) 的诊断.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 生物医学工程 生物医学工程
背景情况:
- 应变分析是评估心室变化的敏感工具.
- 节律失调的RV心肌病 (ARVC) 诊断可能具有挑战性.
- 心血管磁共振 (CMR) 是ARVC的关键成像方式.
研究的目的:
- 评估右心室 (RV) 菌株参数是否可以使用CMR.改善ARVC诊断.
- 为了提高CMR的诊断产量,识别ARVC患者.
- 评估RV菌株分析超出现有CMR标准的增值值.
主要方法:
- 74名ARVC患者和37名对照者的回顾性分析.
- 使用CMR特征追踪来评估RV全球纵向,周围和辐射应变.
- 雇佣接收员操作特征曲线分析和参数评估的尤登指数.
主要成果:
- 与对照组相比,ARVC患者表现出显著减弱的双心膜张力 (P<0.001).
- 全球 RV 纵向菌株 (RV GLS) 是 ARVC 的最强的区分因子 (AUC 0.92).
- RV GLS ≥-19.95%确定了ARVC;当与CMR标准相结合时,诊断准确度达到90%,特别是在边境病例中.
结论:
- RV菌株分析,特别是RV GLS,可以提高ARVC的诊断准确性.
- 结合RV GLS和CMR标准提供了增量诊断价值,特别是在边界ARVC诊断方面.
- 菌株分析通过CMR增强了ARVC的初步评估.
相关概念视频
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
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...
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
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...
01:30Dysrhythmias V: Evaluating Dysrhythmias
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...