Abstract：
BACKGROUND: The alteration of left atrial (LA) phasic function in subacute and chronic pulmonary embolism (PE) patients is unclear.
OBJECTIVE: To investigate LA phasic strain and LA-right ventricular (RV) interaction in subacute and chronic PE patients with different degrees of obstruction by MRI-feature tracking (MRI-FT).
METHODS: Retrospective.
METHODS: One hundred three PE patients (54 subacute [2 weeks to 3 months after initial symptoms], 49 chronic [>3 months after initial symptoms]) and 80 controls.
UNASSIGNED: 3.0 T/balanced steady state free precession sequence.
RESULTS: Patients were divided into mild (pulmonary artery obstruction index [PAOI] < 30%, N = 57), moderate (30% ≤ PAOI < 50%, N = 27), and severe (50% ≥ PAOI, N = 19) PE subgroups. LA reservoir, conduit, and active pump longitudinal strains (εs, εe, and εa) and strain rates (SRs, SRe, and SRa) and biventricular global strains were measured. Determinants of LA strains were investigated.
METHODS: ANOVA, t-tests, Mann-Whitney U tests, linear regression. P < 0.05 was considered statistically significant.
RESULTS: For both subacute and chronic PE patients, LA reservoir, conduit, and active pump strains and strain rates were significantly lower than in controls. However, there were no significant differences in LA strains between patients with subacute and chronic PE (P = 0.933, 0.625, and 0.630 for εs, εe, and εa). The severe PE subgroup had significantly higher εa and SRa than the mild and moderate PE subgroups. LA strains were significantly correlated with RV diameter and biventricular strains, and RV diameter (β = -6.836, -4.084, and -1.899 for εs, εe, and εa) was independently associated with LA strains after adjustment for other factors (R2 = 0.627, 0.536, and 0.437 for εs, εe, and εa).
CONCLUSIONS: LA phasic function evaluated by MRI-FT was significantly impaired in subacute and chronic PE patients, and LA active pump function in the severe PE subgroup was higher than that in the mild and moderate PE subgroups. The independent association between RV diameter and LA strains demonstrates that RV diameter may be an important indicator for monitoring LA dysfunction in PE patients.
METHODS: 3 TECHNICAL EFFICACY: Stage 3.
OBJECTIVE: To investigate LA phasic strain and LA-right ventricular (RV) interaction in subacute and chronic PE patients with different degrees of obstruction by MRI-feature tracking (MRI-FT).
METHODS: Retrospective.
METHODS: One hundred three PE patients (54 subacute [2 weeks to 3 months after initial symptoms], 49 chronic [>3 months after initial symptoms]) and 80 controls.
UNASSIGNED: 3.0 T/balanced steady state free precession sequence.
RESULTS: Patients were divided into mild (pulmonary artery obstruction index [PAOI] < 30%, N = 57), moderate (30% ≤ PAOI < 50%, N = 27), and severe (50% ≥ PAOI, N = 19) PE subgroups. LA reservoir, conduit, and active pump longitudinal strains (εs, εe, and εa) and strain rates (SRs, SRe, and SRa) and biventricular global strains were measured. Determinants of LA strains were investigated.
METHODS: ANOVA, t-tests, Mann-Whitney U tests, linear regression. P < 0.05 was considered statistically significant.
RESULTS: For both subacute and chronic PE patients, LA reservoir, conduit, and active pump strains and strain rates were significantly lower than in controls. However, there were no significant differences in LA strains between patients with subacute and chronic PE (P = 0.933, 0.625, and 0.630 for εs, εe, and εa). The severe PE subgroup had significantly higher εa and SRa than the mild and moderate PE subgroups. LA strains were significantly correlated with RV diameter and biventricular strains, and RV diameter (β = -6.836, -4.084, and -1.899 for εs, εe, and εa) was independently associated with LA strains after adjustment for other factors (R2 = 0.627, 0.536, and 0.437 for εs, εe, and εa).
CONCLUSIONS: LA phasic function evaluated by MRI-FT was significantly impaired in subacute and chronic PE patients, and LA active pump function in the severe PE subgroup was higher than that in the mild and moderate PE subgroups. The independent association between RV diameter and LA strains demonstrates that RV diameter may be an important indicator for monitoring LA dysfunction in PE patients.
METHODS: 3 TECHNICAL EFFICACY: Stage 3.
摘要：
背景：亚急性和慢性肺栓塞（PE）患者左心房（LA）相位功能的改变尚不清楚。
目的：通过MRI特征追踪（MRI-FT）研究亚急性和慢性PE患者不同程度梗阻的LA阶段性应变和LA-右心室（RV）相互作用。
方法：回顾性。
方法：130例PE患者（54例亚急性[初始症状后2周至3个月]，49例慢性[>3个月后初始症状])和80例对照。
■3.0T/平衡稳态自由进动序列。
结果：患者分为轻度（肺动脉阻塞指数[PAOI]<30％，N=57),中度(30%≤PAOI<50%,N=27),严重（50%≥PAOI，N=19)PE亚组。洛杉矶水库,导管,和主动泵纵向应变(εs，εe,和εa)和应变率(SRs，SRe,和SRa）和双心室整体应变进行了测量。研究了LA菌株的决定因素。
方法：方差分析，t检验,Mann-WhitneyU测试,线性回归。P<0.05被认为具有统计学意义。
结果：对于亚急性和慢性PE患者，洛杉矶水库,导管,活性泵菌株和应变率显着低于对照组。然而,亚急性和慢性PE患者的LA菌株没有显着差异（εs的P=0.933、0.625和0.630，εe,和εa）。重度PE亚组的εa和SRa明显高于轻度和中度PE亚组。LA菌株与RV直径和双心室菌株显著相关，和右心室直径(ε=-6.836，-4.084和-1.899，εe,和εa）在调整其他因素后与LA菌株独立相关（εs的R2=0.627、0.536和0.437，εe,和εa）。
结论：通过MRI-FT评估的LA相位功能在亚急性和慢性PE患者中明显受损，重度PE亚组的LA主动泵功能高于轻度和中度PE亚组。RV直径与LA菌株之间的独立关联表明RV直径可能是监测PE患者LA功能障碍的重要指标。
方法：3技术效果：第3阶段。
目的：通过MRI特征追踪（MRI-FT）研究亚急性和慢性PE患者不同程度梗阻的LA阶段性应变和LA-右心室（RV）相互作用。
方法：回顾性。
方法：130例PE患者（54例亚急性[初始症状后2周至3个月]，49例慢性[>3个月后初始症状])和80例对照。
■3.0T/平衡稳态自由进动序列。
结果：患者分为轻度（肺动脉阻塞指数[PAOI]<30％，N=57),中度(30%≤PAOI<50%,N=27),严重（50%≥PAOI，N=19)PE亚组。洛杉矶水库,导管,和主动泵纵向应变(εs，εe,和εa)和应变率(SRs，SRe,和SRa）和双心室整体应变进行了测量。研究了LA菌株的决定因素。
方法：方差分析，t检验,Mann-WhitneyU测试,线性回归。P<0.05被认为具有统计学意义。
结果：对于亚急性和慢性PE患者，洛杉矶水库,导管,活性泵菌株和应变率显着低于对照组。然而,亚急性和慢性PE患者的LA菌株没有显着差异（εs的P=0.933、0.625和0.630，εe,和εa）。重度PE亚组的εa和SRa明显高于轻度和中度PE亚组。LA菌株与RV直径和双心室菌株显著相关，和右心室直径(ε=-6.836，-4.084和-1.899，εe,和εa）在调整其他因素后与LA菌株独立相关（εs的R2=0.627、0.536和0.437，εe,和εa）。
结论：通过MRI-FT评估的LA相位功能在亚急性和慢性PE患者中明显受损，重度PE亚组的LA主动泵功能高于轻度和中度PE亚组。RV直径与LA菌株之间的独立关联表明RV直径可能是监测PE患者LA功能障碍的重要指标。
方法：3技术效果：第3阶段。
