背景:作为一种非侵入性工具,心肌变形显像有助于早期发现心功能不全。然而,基于大规模东亚人群的心肌应变和应变率(SR)的正常参考范围仍然缺乏。本研究旨在基于大量健康中国成年人的心血管磁共振(CMR)特征跟踪(FT),为左心室(LV)和右心室(RV)应变和SR提供参考值。
方法:五百六十六名健康中国成年人(男性占55.1%)无高血压,糖尿病,肥胖也包括在内。在电影CMR上,双心室全球放射状,圆周,和纵向应变(GRS,GCS,和GLS),峰是径向的,圆周,和纵向收缩,和舒张期SR(PSSRR,PSSRC,PSSRL,PDSRR,PDSRC,和PDSRL),以及基底的局部径向和周向应变,中腔,并测量了根尖水平。研究了全球和区域双心室变形指数与年龄和性别的关系。
结果:女性表现出更大的LVGRS(37.6±6.1%vs.32.1±5.3%),GCS(-20.7±1.9%vs.-18.8±1.9%),GLS(-17.8±1.8%vs.-15.6±1.8%),RVGRS(25.1±7.8%vs.22.1±6.7%),GCS(-14.4±3.6%vs.-13.2±3.2%),GLS(-22.4±5.2%vs.-20.2±4.6%),在所有三个坐标方向上的双心室收缩期和舒张期峰值SR(均P<0.05)。对于LV,衰老与GRS振幅增加有关,GCS,减小PDSRR的振幅,PDSRC,PDSRL(均P<0.05)。对于房车,衰老与GRS幅度的增加有关,GCS,GLS,PSSRR,PSSRC,PSSRL,PDSRR的大小减少,PDSRC(均P<0.05)。基底的双心室径向和周向应变测量,中腔,男女年龄和性别均与顶端水平显着相关(均P<0.05)。
结论:我们基于大量年龄范围广泛的健康中国成年人样本,提供了年龄和性别特异性的双心室应变和SR正常值。这些结果可以作为心脏功能评估的参考标准。尤其是中国人。
As a noninvasive tool, myocardial deformation imaging may facilitate the early detection of cardiac dysfunction. However, normal reference ranges of myocardial strain and strain rate (SR) based on large-scale East Asian populations are still lacking. This study aimed to provide reference values of left ventricular (LV) and right ventricular (RV) strain and SR based on a large cohort of healthy Chinese adults using cardiovascular magnetic resonance (CMR) feature tracking (FT).
Five hundred and sixty-six healthy Chinese adults (55.1% men) free of hypertension, diabetes, and obesity were included. On cine CMR, biventricular global radial, circumferential, and longitudinal strain (GRS, GCS, and GLS), and the peak radial, circumferential, and longitudinal systolic, and diastolic SRs (PSSRR, PSSRC, PSSRL, PDSRR, PDSRC, and PDSRL), and regional radial and circumferential strain at the basal, mid-cavity, and apical levels were measured. Associations of global and regional biventricular deformation indices with age and sex were investigated.
Women demonstrated greater magnitudes of LV GRS (37.6 ± 6.1% vs. 32.1 ± 5.3%), GCS (- 20.7 ± 1.9% vs. - 18.8 ± 1.9%), GLS (- 17.8 ± 1.8% vs. - 15.6 ± 1.8%), RV GRS (25.1 ± 7.8% vs. 22.1 ± 6.7%), GCS (- 14.4 ± 3.6% vs. - 13.2 ± 3.2%), GLS (- 22.4 ± 5.2% vs. - 20.2 ± 4.6%), and biventricular peak systolic and diastolic SR in all three coordinate directions (all P < 0.05). For the LV, aging was associated with increasing amplitudes of GRS, GCS, and decreasing amplitudes of PDSRR, PDSRC, PDSRL (all P < 0.05). For the RV, aging was associated with an increase in the magnitudes of GRS, GCS, GLS, PSSRR, PSSRC, PSSRL, and a decrease in the magnitude of PDSRR, PDSRC (all P < 0.05). Biventricular radial and circumferential strain measurements at the basal, mid-cavity, and apical levels were all significantly related to age and sex in both sexes (all P < 0.05).
We provide age- and sex-specific normal values of biventricular strain and SR based on a large sample of healthy Chinese adults with a broad age range. These results may be served as a reference standard for cardiac function assessment, especially for the Chinese population.