使用炼CMR对运动诱导的心肌变形的量化
Manuel A Morales1, Fahime Ghanbari1, Jennifer Rodriguez1
1Departments of Medicine (Cardiovascular Division) and Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
概括
生理压力可以揭示休息时看不到的心脏问题. 运动心血管磁共振 (Ex-CMR) 与心肌扭转储备 (MTR) 有效地识别了心力衰竭中心脏力学异常的患者.
科学领域:
- 心脏病学 心脏病学
- 生物医学工程 生物医学工程
- 医疗成像医学成像
背景情况:
- 生理压力可以揭露在休息时不明显的心肌变形.
- 运动心血管磁共振 (Ex-CMR) 在休息和运动期间评估心肌变形.
- 心肌扭转储量 (MTR) 是一种用于运动诱导的旋转变形的新型指标.
研究的目的:
- 开发和评估MTR作为心肌力学异常的标志物,用于心力衰竭患者的心脏衰竭和保存的喷射分数 (HFpEF).
- 评估MTR在区分HFpEF患者与健康对照和非心脏呼吸障碍患者中的有用性.
主要方法:
- 单拍心肌标记图像是在休息和运动后使用3T Ex-CMR获得的.
- 测量了顶部和基底旋转角度来计算扭矩,MTR被定义为应力与静止扭矩的比率.
- 对67名参与者的回顾性分析 (24对照组,17非心脏性呼吸障碍,15运动诱导的HFpEF,11明显的HFpEF) 进行了侵入性运动测试.
主要成果:
- 测量MTR显示出良好的可重复性 (观察者间ICC=0.90,观察者内部ICC=0.95).
- 与健康对照组 (1.7±0.4) 和非心脏呼吸障碍 (1.6±0.4) 组相比,在运动诱导的HFpEF (1.1±0.1) 和明显的HFpEF (1.2±0.2) 中,MTR显著降低.
- 在健康对照组和非心脏呼吸障碍患者之间没有观察到MTR的显著差异 (p=0.978).
结论:
- 从Ex-CMR获得的MTR量化了运动诱导的旋转变形和机械储备.
- MTR有效地区分了运动诱导或明显的HFpEF患者与健康个体以及非心脏呼吸障碍患者.
- MTR显示出作为异常心肌对运动反应的有价值标记物的潜力.
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