心脏磁共振特征追踪技术在高海拔地区扩张型心肌病的初步研究

王哲涛; 王春华; 尹红科; 赵思斯; 索靖航; 王磊; 陈榆舒; 周鹏; 郜发宝

doi:10.12182/20250460201

心脏磁共振特征追踪技术在高海拔地区扩张型心肌病的初步研究

Preliminary Study of Dilated Cardiomyopathy at a High Altitude Based on Cardiac Magnetic Resonance Feature Tracking

摘要

摘要:
目的探讨心脏磁共振特征追踪（cardiovascular magnetic resonance feature tracking, CMR-FT）技术在高海拔地区扩张型心肌病（dilated cardiomyopathy, DCM）患者心肌应变中的初步应用。
方法回顾性搜集高海拔DCM患者（patients with DCM at high altitude, DCM-H）、平原DCM患者（patients with DCM at plain, DCM-P）、高海拔健康志愿者（healthy volunteers at high altitude, HV-H）、平原健康志愿者（healthy volunteers at high altitude, HV-P）各29例、27例、23例、24例。所有受试者均进行了3.0T MRI快速平衡稳态自由进动电影序列扫描。所获得的CMR图像使用cvi42后处理软件进行分析，获得左室心功能参数及心肌应变参数。
结果 DCM-H组左室舒张末容积和收缩末容积高于HV-H组，射血分数、每搏输出量低于HV-H组（所有P<0.01）。DCM-H组与DCM-P组心功能差异无统计学意义。与HV-H相比，DCM-H组整体径向、周向、纵向应变（%）（14.5±6.5 vs. 34.2±10.7; －11.1±4.4 vs. －19.9±2.8; －7.7±3.2 vs. －13.6±4.1）绝对值更低，差异有统计学意义（所有P<0.001）。DCM-H组比DCM-P组整体径向、周向、纵向应变绝对值（%）高（14.5±6.5 vs. 7.0±2.7; －11.1±4.4 vs. －5.4±2.2; －7.7±3.2 vs. －4.3±1.7; 所有P<0.01）。
结论高海拔DCM患者的心肌应变低于高海拔健康志愿者，高于平原DCM患者。CMR-FT可以定量评估高海拔地区DCM患者心肌收缩能力，在临床应用中具有较好的前景。

Abstract:
Objective To investigate the application of cardiovascular magnetic resonance feature tracking (CMR-FT) in assessing myocardial strain in dilated cardiomyopathy (DCM) patients residing at high altitudes.
Methods We retrospectively enrolled 29 DCM patients living at high altitudes (DCM-H), 27 DCM patients living in a low-altitude plain environment (DCM-P), 23 healthy volunteers living at a high altitude (HV-H), and 24 healthy volunteers living in a low-altitude plain environment (HV-P). All subjects underwent cine MRI scanning using a 3.0T rapid steady-state free precession sequence. The CMR images thus acquired were analyzed using cvi42, a post-processing software, to obtain left ventricular function and myocardial strain parameters.
Results Compared with the HV-H group, the DCM-H group showed higher left ventricle end-diastolic volume (LVEDV) and left ventricle end-systolic volume (LVESV), and lower left ventricular ejection fraction (LVEF) and stroke volume ( LVSV) (all P < 0.01). No significant difference was observed in cardiac function between the DCM-H and DCM-P groups (all P > 0.05). The absolute values of global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS) in the DCM-H group were lower than those in the HV-P group (14.5 ± 6.5% vs. 34.2 ± 10.7%, －11.1 ± 4.4% vs. －19.9 ± 2.8%, and －7.7 ± 3.2% vs. －13.6 ± 4.1%, respectively), with the differences being statistically significant (all P < 0.001). The DCM-H group had higher absolute GRS, GCS, and GCS values than the DCM-P group did (14.5 ± 6.5% vs. 7.0 ± 2.7%, －11.1 ± 4.4% vs. －5.4 ± 2.2%, and －7.7 ± 3.2% vs. －4.3 ± 1.7%, respectivley, all P < 0.01).
Conclusion Myocardial strain in DCM patients living at a high altitude is lower than that in healthy volunteers living at a high altitude, but higher than that in DCM patients living in a low-altitude plain environment. CMR-FT can be used to quantitatively assess myocardial contractility in DCM patients living at a high altitude, showing promise for clinical application.

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