目的:将心脏磁共振成像(CMR)应用于尿毒症心肌病(UC)的详细心肌表征,高血压心肌病(HTN),和肥厚型心肌病(HCM)旨在丰富对UC病因学的理解并进一步支持治疗策略的发展。
方法:从2016年6月至2023年3月,共有152名患者(年龄:49.2±9.9岁;65.8%男性)接受了常规CMR。回顾过去,53例UC患者,39例HTN患者,30例HCM患者,包括30名健康对照。功能分析,左心室和左心房的特征跟踪,并进行心肌T1,T2和T2*标测.统计分析包括Pearson相关性和ROC分析,以定义组间的相关性和鉴别器。
结果:UC患者与其他三组相比,表现出明显更高的天然T1(所有p<0.001)和T2(所有p<0.002)值。与HTN和HCM患者相比,UC患者显示出更高的左心房储层应变率(全部p<0.001)和左心房导管应变率(全部p<0.001)绝对值。UC患者的T1和T2值之间存在显着相关性(r=0.511,p<0.001)。T1值和应变参数的组合是UC和HTN患者(AUC=0.872,95%CI:0.801-0.943)以及UC和HCM患者(AUC=0.840,95%CI:0.746-0.934)之间的最佳判别指标。
结论:UC揭示了T1和T2作图所证明的区别组织特征,以及与HTN和HCM等其他肥大表型相比,区分功能菌株参数。
■在UC患者中使用CMR成像提供了增量信息来阐明其复杂的病因,促进关于有效治疗途径的持续讨论。
结论:这项研究调查了尿毒症,高血压,和使用心脏MRI的肥厚型心肌病。UC患者具有较高的T1和T2值,并且更好地保留了心脏功能。合并的应变和T1值将UC与其他心肌病区分开。
OBJECTIVE: To apply cardiac magnetic resonance imaging (CMR) for detailed myocardial characterization in uremic cardiomyopathy (UC), hypertensive cardiomyopathy (HTN), and hypertrophic cardiomyopathy (HCM) aiming to enrich the understanding of UC\'s etiology and further support the development of therapeutic strategies.
METHODS: A total of 152 patients (age: 49.2 ± 9.9 years; 65.8% male) underwent routine CMR from June 2016 to March 2023. Retrospectively, 53 patients with UC, 39 patients with HTN, 30 patients with HCM, and 30 healthy controls were included. Functional analysis, feature tracking of the left ventricle and left atrium, and myocardial T1, T2, and T2* mapping were performed. Statistical analysis included Pearson correlation and ROC analysis to define correlations and discriminators between groups.
RESULTS: UC patients demonstrated significantly higher native T1 (p < 0.001 for all) and T2 (p < 0.002 for all) values compared with the other three groups. UC patients revealed higher left atrial reservoir strain rate (p < 0.001 for all) and left atrial conduit strain rate (p < 0.001 for all) absolute values as compared with HTN and HCM patients. A significant correlation between T1 and T2 values in UC patients (r = 0.511, p < 0.001) was found. The combination of T1 values and strain parameters was the best discriminator between UC and HTN patients (AUC = 0.872, 95% CI: 0.801-0.943) and between UC and HCM patients (AUC = 0.840, 95% CI: 0.746-0.934).
CONCLUSIONS: UC reveals distinguishing tissue characteristics as evidenced by T1 and T2 mapping, as well as distinguishing functional strain parameters as compared with other hypertrophic phenotypes such as HTN and HCM.
UNASSIGNED: The use of CMR imaging in UC patients offers incremental information to elucidate its complex etiology, contributing to ongoing discourse on effective treatment pathways.
CONCLUSIONS: This study investigated uremic, hypertensive, and hypertrophic cardiomyopathies using cardiac MRI. UC patients have higher T1 and T2 values and better preserved cardiac function. Combined strain and T1 values distinguish UC from other cardiomyopathies.