摘要
目的探讨冠状动脉慢血流(CSF)患者心脏MR(CMR)评价的左室结构功能、心肌静息灌注及心肌应变的改变。方法回顾性搜集经冠状动脉血流帧数(TFC)诊断为CSF且1周内行CMR检查的患者35例(CSF组),同期纳入健康对照组21例。比较两组间基线资料、左室结构功能参数、静息灌注参数及心肌应变参数的差异,左室结构功能参数包括左室收缩末容积(ESV)、左室舒张末容积(EDV)、左室收缩末容积指数(LVESVi)、心肌质量指数(LVMi)、左室射血分数(LVEF)等;静息灌注参数包括最大上升斜率(upslope)、最大信号强度达峰时间(TTM)、信号强度最大值(SImax);左室心肌应变参数包括径向应变(GRS)、周向应变(GCS)和纵向应变(GLS)。进一步明确TFC与心肌应变参数的相关性。结果与对照组相比,CSF患者体重指数、低密度脂蛋白胆固醇和甘油三酯水平及高血压患病率增高(P<0.05)。CMR评价的ESV、EDV、LVM、LVESVi、LVMi均较对照组增高,LVEF减低(63.92±7.10 vs 57.37±9.03,P<0.05)。静息心肌灌注显示CSF组SImax、upslope较对照组减低。左室心肌应变参数GRS、GCS和GLS均较对照组明显减低(P<0.05)。进一步相关分析前降支和回旋支的TFC和GLS呈负相关(P<0.05)。结论CSF虽然LVEF正常,但已存在结构功能改变,包括心肌质量增加、舒张功能减退、静息灌注和心肌应变减低,且心肌应变与TFC呈负相关。因此,CMR有助于对CSF患者早期心脏结构功能改变的评价。
Objective To investigate the changes of left ventricular structure and function,rest myocardial perfusion and myocardial strain in patients with coronary slow flow(CSF)assessed by cardiac MR(CMR).Methods 35 patients(CSF group)who were diagnosed as CSF by thrombolysis in myocardial infarction frame count(TFC)and underwent CMR examination within one week in our hospital were retrospectively enrolled,and 21 healthy subjects who underwent CMR were included.The differences in baseline,left ventricular structural function parameters,rest perfusion imaging and myocardial strain parameters between the two groups were compared.Left ventricular structural function parameters included left ven-tricular end systolic volume(ESV),end diastolic volume(EDV),end systolic volume index(LVESVi),cardiac mass index(LVMi),left ventricular ejection fraction(LVEF);rest perfusion imaging parameters included upslope,time to maximum signal intensity(TTM),maximum signal intensity(SImax);left ventricular myocardial strain parameters included global radial strain(GRS),global circumferential strain(GCS)and global longitudinal strain(GLS).Results Compared with the control group,the body mass index,low-density lipoprotein cholesterol and triglyceride and the prevalence of hyperten-sion in CSF patients were increased(P<0.05).ESV,EDV,LVM,LVESVi,LVMi assessed by CMR were higher,and LVEF decreased(63.92±7.10 vs 57.37±9.03,P<0.05).Rest myocardial perfusion imaging showed that SImax and upslope in the CSF group were lower.The left ventricular myocardial strain parameters GRS,GCS and GLS were significant-ly lower than those in the control group(P<0.05).Further correlation analysis showed that the TFC and GLS of left ante-rior descending(LAD)and left circumflex(LCX)were negatively correlated(P<0.05).Conclusion Although LVEF is preserved in CSF,there are already structural and functional changes,including increased myocardial mass,decreased di-astolic function,impaired rest myocardial perfusion,and myocardial strain.More importantly,myocardial strain is
作者
张耘博
赵新湘
孙林
马运婷
张莉
ZHANG Yunbo;ZHAO Xinxiang;SUN Lin(Department of Radiology,the Second Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650000,P.R.China)
出处
《临床放射学杂志》
北大核心
2024年第1期52-57,共6页
Journal of Clinical Radiology
基金
国家自然科学基金(编号:82160332)
云南省重大专项(编号:202203AC100007)
昆医联合专项-重点项目(编号:202101AB070081)
昆明医科大学第二附属医院院内临床研究项目(编号:yn IIT2021010)。
关键词
冠状动脉慢血流
心脏磁共振
左心室应变
冠状动脉微循环功能障碍
Coronary slow flow
Cardiac magnetic resonance
Left ventricular strain Coronary microvascular dysfunction
