Abstract:
The aim was to investigate LA strain by feature tracking cardiac MRI in mitral stenosis (MS) patients before and after percutaneous balloon mitral valvuloplasty (PBMV). Patients underwent cardiac MRI before and after successful PBMV (n = 18). Mitral valve area, transmitral velocity and gradients, LA volumes and ejection fraction (LAEF) were measured. LA strain feature tracking analysis was used to calculate LA reservoir, conduit, and booster strain. LA strain, LA volumes, LAEF and mitral valve severity indices were compared before and after PBMV. Correlations between LA strain and other cardiac MRI parameters were assessed. After PBMV, mitral valve area increased from 1.18 ± 0.25 cm2 to 2.26 ± 0.27 cm2, p < 0.001. Transmitral peak velocity decreased from 1.7 ± 0.37 m/s to 1.3 ± 0.27 m/s, p < 0.001. Transmitral peak gradient decreased from 12.4 ± 4.8 mmHg to 6.8 ± 2.9 mmHg, p < 0.001, and mean gradient decreased from 6.9 ± 3.8 mmHg to 2.9 ± 1.4 mmHg, p < 0.001. Maximal LA volume decreased from 73.1 ± 14.2 ml/m2 to 62.7 ± 16.3 ml/m2, p = 0.018; corrected p value = 0.054. LAEF increased from 36.3 ± 8.7% to 44.4 ± 9.5%, p = 0.010. Reservoir strain increased from 11.7 ± 3.1% to 14.9 ± 3.6% after PBMV, p = 0.009, and conduit strain from 3.8 ± 2% to 6 ± 2.3%, p = 0.005. Booster strain insignificantly increased after PBMV. Cardiac MRI feature tracking provides information on the 3 LA functional phases. Significant improvement was observed in reservoir and conduit functions after successful PBMV.
摘要:
目的是通过经皮球囊二尖瓣成形术(PBMV)前后的二尖瓣狭窄(MS)患者的特征追踪心脏MRI来研究LA应变。患者在成功PBMV之前和之后接受了心脏MRI(n=18)。二尖瓣面积,传播速度和梯度,测量LA体积和射血分数(LAEF)。LA应变特征跟踪分析用于计算LA储层,导管,和助推器应变。LA菌株,洛杉矶卷,比较PBMV前后的LAEF和二尖瓣严重程度指数。评估LA应变与其他心脏MRI参数之间的相关性。PBMV之后,二尖瓣面积从1.18±0.25cm2增加到2.26±0.27cm2,p<0.001。经二尖瓣峰值速度由1.7±0.37m/s降至1.3±0.27m/s,p<0.001。经二尖瓣峰梯度从12.4±4.8mmHg降至6.8±2.9mmHg,p<0.001,平均梯度从6.9±3.8mmHg降至2.9±1.4mmHg,p<0.001。最大LA体积从73.1±14.2ml/m2降至62.7±16.3ml/m2,p=0.018;校正p值=0.054。LAEF从36.3±8.7%增加到44.4±9.5%,p=0.010。PBMV后储层应变从11.7±3.1%增加到14.9±3.6%,p=0.009,导管应变从3.8±2%到6±2.3%,p=0.005。PBMV后增强菌株没有显着增加。心脏MRI特征跟踪提供了关于3个LA功能阶段的信息。成功的PBMV后,观察到储层和导管功能的显着改善。