Measurement of Turbulent Kinetic Energy in Hypertrophic Cardiomyopathy Using Triple-velocity Encoding 4D Flow MR Imaging.

IF 2.5 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Magnetic Resonance in Medical Sciences Pub Date : 2024-01-01 Epub Date: 2022-12-13 DOI:10.2463/mrms.mp.2022-0051

Kotomi Iwata, Tetsuro Sekine, Junya Matsuda, Masaki Tachi, Yoichi Imori, Yasuo Amano, Takahiro Ando, Makoto Obara, Gerard Crelier, Masashi Ogawa, Hitoshi Takano, Shinichiro Kumita

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引用次数: 0

Abstract

Purpose: The turbulent kinetic energy (TKE) estimation based on 4D flow MRI has been currently developed and can be used to estimate the pressure gradient. The objective of this study was to validate the clinical value of 4D flow-based TKE measurement in patients with hypertrophic cardiomyopathy (HCM).

Methods: From April 2018 to March 2019, we recruited 28 patients with HCM. Based on echocardiography, they were divided into obstructed HCM (HOCM) and non-obstructed HCM (HNCM). Triple-velocity encoding 4D flow MRI was performed. The volume-of-interest from the left ventricle to the aortic arch was drawn semi-automatically. We defined peak turbulent kinetic energy (TKE_peak) as the highest TKE phase in all cardiac phases.

Results: TKE_peak was significantly higher in HOCM than in HNCM (14.83 ± 3.91 vs. 7.11 ± 3.60 mJ, P < 0.001). TKE_peak was significantly higher in patients with systolic anterior movement (SAM) than in those without SAM (15.60 ± 3.96 vs. 7.44 ± 3.29 mJ, P < 0.001). Left ventricular (LV) mass increased proportionally with TKE_peak (P = 0.012, r = 0.466). When only the asymptomatic patients were extracted, a stronger correlation was observed (P = 0.001, r = 0.842).

Conclusion: TKE measurement based on 4D flow MRI can detect the flow alteration induced by systolic flow jet and LV outflow tract geometry, such as SAM in patients with HOCM. The elevated TKE is correlated with increasing LV mass. This indicates that increasing cardiac load, by pressure loss due to turbulence, induces progression of LV hypertrophy, which leads to a worse prognosis.

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利用三倍速度编码四维血流磁共振成像测量肥厚型心肌病的湍流动能

目的：目前已开发出基于四维流磁共振成像的湍流动能（TKE）估算方法，可用于估算压力梯度。本研究旨在验证基于 4D 流量的 TKE 测量在肥厚型心肌病（HCM）患者中的临床价值：从 2018 年 4 月到 2019 年 3 月，我们招募了 28 名 HCM 患者。根据超声心动图，他们被分为梗阻型 HCM（HOCM）和非梗阻型 HCM（HNCM）。进行了三重速度编码 4D 血流磁共振成像。半自动绘制了从左心室到主动脉弓的感兴趣容积。我们将湍流动能峰值（TKEpeak）定义为所有心相中最高的 TKE 相位：HOCM 的 TKEpeak 明显高于 HNCM（14.83 ± 3.91 vs. 7.11 ± 3.60 mJ，P < 0.001）。收缩期前移 (SAM) 患者的 TKEpeak 明显高于无 SAM 患者（15.60 ± 3.96 vs. 7.44 ± 3.29 mJ，P < 0.001）。左心室（LV）质量与 TKE 峰成正比增加（P = 0.012，r = 0.466）。当仅提取无症状患者时，观察到更强的相关性（P = 0.001，r = 0.842）：结论：基于四维血流磁共振成像的TKE测量可检测出HOCM患者由收缩期血流喷射和左心室流出道几何形状（如SAM）引起的血流改变。TKE 的升高与左心室质量的增加相关。这表明，湍流造成的压力损失会增加心脏负荷，诱发左心室肥厚，从而导致预后恶化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Magnetic Resonance in Medical Sciences RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

5.80

自引率

20.00%

发文量

审稿时长

>12 weeks

期刊介绍： Magnetic Resonance in Medical Sciences (MRMS or Magn Reson Med Sci) is an international journal pursuing the publication of original articles contributing to the progress of magnetic resonance in the field of biomedical sciences including technical developments and clinical applications. MRMS is an official journal of the Japanese Society for Magnetic Resonance in Medicine (JSMRM).