分子影像学杂志2024，Vol.47Issue(1)：7-13,7.DOI:10.12122/j.issn.1674-4500.2024.01.02
基于CT获得的心肌应变参数在肥厚型心肌病和高血压性心脏病中的应用
CT application in early left ventricular function assessment and differential diagnosis:the crucial role of myocardial strain parameters in hypertrophic cardiomyopathy and hypertensive heart disease
摘要
Abstract
Objective To explore the feasibility of myocardial strain(MS)parameters obtained through CT technology for assessing early left ventricular function in hypertrophic cardiomyopathy(HCM)and hypertensive heart disease(HHD),as well as the capability of this parameter to differentiate between these two diseases,providing clinical reference.Methods This study was a retrospective analysis involving 205 adult participants with negative results from cardiac coronary imaging examinations conducted at the Xijing Hospital of Air Force Medical University from December 2021 to January 2023.Based on inclusion and exclusion criteria,the participants were categorized into three groups:HCM(n=70),HHD(n=65),and healthy control group(n=70).Subsequently,post-processing software was utilized to quantify left ventricular morphological characteristics,traditional cardiac function parameters,and MS parameters among the three groups.The differences in these parameters were compared and their discriminative abilities between the two diseases were assessed.Results Compared to the healthy control group,both the HCM and HHD groups exhibited increased maximal left ventricular wall thickness and left ventricular mass index(9.25±1.68 vs 15.32±1.67 vs 18.01±2.24;56.64±19.57 vs 86.90±12.31 vs 106.27±19.56,respectively,P<0.001).Meanwhile,the absolute values of MS were reduced in both groups(myocardial global circumferential strain:-25.80±3.74 vs-23.00±4.49 vs-21.03±4.97;endocardial global circumferential strain:-40.95±8.13 vs-35.86±7.90 vs-31.85±9.16;myocardial global radial strain:81.26±37.76 vs 66.99±18.37 vs 55.31±23.19,P<0.001),with the longitudinal strain showing the most significant decrease(myocardial global longitudinal strain:-23.03±3.84 vs-19.86±2.22 vs-15.47±4.28;endocardial global longitudinal strain:-30.35±5.35 vs-25.01±3.62 vs 21.92±8.16,P<0.001).Multivariate Logistic regression analysis revealed that the combination model of maximal left ventricular wall thickness,left ventricular mass index,and myocardial global longitudinal strain had the largest area under the ROC curve of 0.930(sensitivity:97%,specificity:83%).Conclusion The MS parameters obtained from CT imaging can accurately assess early left ventricular functional impairment in patients with HCM and HHD,with longitudinal strain showing the most significant impairment.Among the parameters obtained,the combination model of maximal left ventricular wall thickness,left ventricular mass index,and myocardial global longitudinal strain demonstrated the best effectiveness in distinguishing between these two diseases.These discoveries hold promise for providing more accurate diagnostic and therapeutic guidance in clinical practice.关键词
肥厚型心肌病/高血压性心脏病/计算机断层成像/心肌应变Key words
hypertrophic cardiomyopathy/hyperten-sive heart disease/computed tomography imaging/myocardial strain引用本文复制引用
何泽明,郑敏文,赵宏亮,韩冬,于楠,张喜荣,贺太平..基于CT获得的心肌应变参数在肥厚型心肌病和高血压性心脏病中的应用[J].分子影像学杂志,2024,47(1):7-13,7.基金项目
陕西省重点产业创新链项目(2021ZDLSF04-10) （2021ZDLSF04-10）
