摘要
目的探讨心脏MRI（CMRI）时间容量曲线评价左心室舒张功能的可行性，分析肥厚型心肌病（HCM）左心室时间容量曲线改变的趋势及特点。方法分别获取17例HCM患者及12名健康志愿者的MR左心室二腔长轴及短轴面电影图像，在工作站进行图像后处理，利用左心室自动分割技术重组左心室时间容量曲线，并通过该曲线计算出左心室舒张平台期时间、不同比例舒张容量恢复（DVR）时间及其相应的充盈速率等。采用多重线性回归分析对组间DVR时间及速率进行检验分析。结果室间隔HCM患者组左心室50％、70％DVR时间较对照组延迟[分别为（8．9±1．3）和（7．7±0．8）期相，F=6．787，P=0．016；（11．3±1．6）和（9．7±1．8）期相，F=4．927，P=0．036]，左心室舒张平台期时间较对照组明显缩短[（1．8±1．7）和（4．1±1．4）期相，t=6．787，P〈0．01]；室间隔型HCM患者组30％、50％DVR充盈速率较对照组减低[分别为（0．22±0．11）和（0．40±0．15）ml／ms，F：12．916，P〈0．01；（0．20±0．09）和（0．30±0．10）ml／ms，F=7．121，P=0．014]，70％、80％、90％DVR充盈速率与对照组间差异无统计学意义。HCM伴发纤维化组左心室50％、70％、80％DVR时间较对照组延迟[分别为（9．6±1．0）和（7．9±1．5）期相，F=5．000，P=0．045；（12．3±1．4）和（9．6±1．8）期相，F=8．039，P=0．015；（13．1±1．4）和（10．9±1．9）期相，F=5．060，P=0．044]，2组间DVR速率差异无统计学意义。结论左心室时间容量曲线可用于详细评估左心室舒张功能改变；HCM患者左心室舒张功能不全主要发生在舒张早期，且伴发平台期时间的缩短；心肌纤维化可加重HCM左心室早期舒张功能不全。
Objective To determine the feasibility of using left ventficular volume-time curve in the evaluation of left ventricular diastolic function, and to analyze characteristics of left ventricular volume-time curve changes in hypertrophic cardiomyopathy （HCM）. Methods Seventeen cases of HCM and 12 healthy volunteers received cardiac MRI （CMRI） examination, and left ventricular （LV） 2-chamber long and short axis cine imaging were performed, LV volume-time curves were reconstructed and platform time, different diastolic volume recovery （DVR） time and their corresponding filling velocity were calculated from LV volume-time curve off-line. The DVR time and their corresponding filling velocity were analyzed by using multiple linear regression analysis. Results Compared with the group of healthy volunteers, ventricular septal HCM group had delayed left ventricular 50%, 70% DVR time [ （ 8.9 ± 1.3 ） versus （ 7. 7 ± 0. 8 ） phase, F=6.787, P=0.016;（11.3 ±1.6） versus（9.7 ± 1.8） phase, F=4.927,P=0.036] and shortened plateau time [ （ 1.8 ± 1.7） versus （4. 1 ± 1.4 ） phase, t = 6. 787, P 〈 0. 01 ]. Ventricular septal HCM group had reduced 30% , 50% DVR filling rates [ （0. 22 ± 0. 11 ） versus （0. 40 ± 0. 15 ） ml/ms, F = 12.916,P〈0.01;（0.20 ±0.09） versus（0.30 ±0.10） ml/ms, F=7.121, P=0.014] compared with those in the group of healthy volunteers. But 70% , 80% , 90% DVR filling rates showed no statisticallysignificant different in the two groups. In HCM patients, myocardial fibrosis caused 50% , 70% , 80% DVR time delay [ （9. 6 ± 1.0） versus（7. 9 ± 1.5 ） phase, F = 5. 000, P = 0. 045 ; （ 12. 3 ± 1.4 ） versus （ 9.6 ± 1.8）phase,F= 8.039,P=0.015;（13.1±1.4 ） versus（10.9±1.9）phase,F=5.060, P=0.044], but no significant difference of DVR filling rate was found between the two groups. Conclusions Left ventricular volume curve analysis techniques can be used for detailed evaluation of left ventricular diastolic function. The left ventricular diastolic dysfunction of hypertrophic cardiomyopathy occurs mainly in early diastolic period, and accompanied by the shortening of the plateau time. Myocardial fibrosis can aggravate early left ventricular diastolic dysfunction of hypertrophic cardiomyopathy.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2012年第10期896-901,共6页
Chinese Journal of Radiology
基金
基金项目：国家自然科学基金资助项目（30870671）
浙江省自然科学基金资助项目（R207119）
关键词
心室功能
左
心肌病
肥厚型
磁共振成像
Ventricular function, left
Cardiomyopathy, hypertropahic
Magnetic resonance imaging
