心血管MR组织追踪技术定量评估肥厚型心肌病右心室心肌应变

目的 探讨心脏MR组织追踪（CMR-TT）技术评价肥厚型心肌病（HCM）右心室功能的可行性及右心室应变与左心室应变的相关性。方法 对32例HCM患者（HCM组）及32名健康志愿者（对照组）行CMR电影序列扫描，测量心功能及左、右心室应变参数。结果 HCM组左心室质量较对照组明显增高（t=11.26，P<0.001），其余左心功能参数（左心室射血分数、舒张末期容积、收缩末期容积）2组间差异均无统计学意义（P均>0.05）。与对照组比较，HCM组左心室、右心室整体圆周应变（GCS）、整体径向应变（GRS）和整体纵向应变（GLS）均明显减低（P均<0.05）；除左、右心室基底部径向应变外，HCM组各节段局部应变较对照组减低（P均<0.05）。HCM组右心室GRS与左心室GRS呈正相关（r=0.375，P=0.034），与左心室GLS呈负相关（r=-0.466，P=0.007）；右心室GCS与左心室GCS、GLS均呈正相关（r=0.531、0.462，P=0.002、0.008）。结论 右心室节段应变、整体应变能敏感地反映HCM右心室心肌收缩功能；HCM患者在左心室射血分数减低前左、右心室心肌收缩功能已存在受损；HCM右心室与左心室心肌收缩功能受损存在一定相关性。

Cardiac MR tissue tracking for quantitative assessment of right ventricular strain in hypertrophic cardiomyopathy

Objective To explore the feasibility of cardiac MR tissue tracking (CMR-TT) in assessing right ventricular (RV) function and strain of hypertrophic cardiomyopathy (HCM) patients and the correlation of RV strain and left ventricular strain. Methods Totally 32 patients with HCM (HCM group) and 32 healthy volunteers (control group) underwent cardiac MR film sequence scanning. Cardiac function and ventricular strain were measured. Results Left ventricular mass of HCM group was significantly higher than that of control group (t=11.26, P<0.001), whereas left ventricular function parameters including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume, left ventricular end-systolic volume had no differences between HCM group and control group (all P>0.05). In HCM group, the global radial strain (GRS), global circumferential strain (GCS) and global longitudinal strain (GLS) in the left ventricle and right ventricle were significantly lower than those in the control group (all P<0.05). In addition to the basal radial strain of both ventricles, the segment local strain in HCM group reduced compared with that of control group (all P<0.05). GRS of the right ventricle positively correlated with GRS of left ventricle (r=0.375, P=0.034) and negatively correlated with GLS of left ventricle (r=-0.466, P=0.007), while GCS of the right ventricle positively correlated with GCS and GLS of left ventricle (r=0.531, 0.462, P=0.002, 0.008). Conclusion The segment strain and global strain of right ventricle can sensitively respond the systolic function in HCM. Both left and right ventricular systolic function of HCM patients have been impaired before LVEF reduced. The systolic dysfunction of right and left ventricle have correlation to a certain degree.