【摘要】 目的 探讨应用磁共振特征追踪技术分段评估高血压心脏病患者左心室周向心肌形变率的变化。资料与方法 回顾性分析2018年1月—2020年6月于焦作市第二人民医院及郑州大学第一附属医院确诊的高血压心脏病患者51例，其中左心室射血分数（LVEF）<50%24例，LVEF≥50%27例。另取40名健康者为对照组，均行心脏磁共振检查，采用心肌特征追踪技术对左心室短轴进行分段分析，获得心底部周向形变、中间部周向形变、心尖部周向形变及各项左心室功能参数，分析3组连续变量的差异，评估各心功能参数与周向心肌形变参数之间的相关性。结果 LVEF<50%高血压心脏病组心底部、中间部和心尖部周向形变均低于对照组（t=11.11、13.82、10.83,P均<0.05）和LVEF≥50%高血压心脏病组（t=10.11、9.17、10.34,P均<0.05）;LVEF≥50%高血压心脏病组中间部周向形变低于对照组（t=4.65,P<0.05）。LVEF≥50%高血压心脏病组中，LVEF与心底部周向形变（r=-0.447,P=0.019）、中间部周向形变（r=-0.494,P=0.009）、心尖部周向形变（r=-0.505,P=0.007）呈负相关，舒张末期心肌质量与中间部周向形变（r=0.557,P=0.003）、中间部周向形变（r=0.430,P=0.025）呈正相关。结论 心肌特征追踪技术分段分析左心室形变能力可以定位分析各段心肌受损的严重程度和定量分析心室壁力学改变。更多还原

【Abstract】 Purpose To explore the application of magnetic resonance feature tracking technique to evaluate the changes of left ventricular circumferential myocardial strain in patients with hypertensive heart disease(HHD). Materials and Methods A total of 51 patients diagnosed with HHD at Jiaozuo Second Hospital of People and the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2020, including 24 patients with left ventricular ejection fraction(LVEF) <50% and 27 patients with LVEF≥50%; 40 healthy individuals taken as the control group were retrospectively enrolled, all subjects underwent cardiac magnetic resonance examination. The myocardial feature tracking technique was used to analyze the left ventricular short axis, basal circumferential strain, middle circumferential strain, apical circumferential strain and various parameters of left ventricular function were further obtained. The differences in continuity variables among three groups were examined, the correlation between cardiac function parameters and peripheral cardiac deformation parameters. Results Basal circumferential strain, middle circumferential strain, and apical circumferential strain of LVEF<50% HHD group were significantly lower than those of the control group(t=11.11, 13.82, 10.83, all P<0.05) and LVEF≥50% HHD group(t=10.11, 9.17, 10.34, all P<0.05).Middle circumferential strain of the LVEF≥50% HHD group was significantly lower than those of control group(t=4.65, P<0.05). Correlation analysis showed that LVEF of LVEF≥50% HHD group was negatively correlated with basal circumferential strain(r=-0.447, P=0.019),middle circumferential strain(r=-0.494, P=0.009) and apical circumferential strain(r=-0.505, P=0.007); however, end-diastolic myogenic mass(ESMM) was positively correlated with median circumferential strain(r=0.557, P=0.003) and median circumferential strain(r=0.430,P=0.025). Conclusion The segmented analysis of left ventricular strain measured by myocardial feature tracking technique could analyze the severity of each segment of myocardial injury and quantitatively analyze the mechanical changes of ventricular wall, providing more parameters for the evaluation of myocardial dysfunction in patients with HHD.更多还原