Cardiovascular magnetic resonance feature tracking derived strain analysis can predict return to training following exertional heatstroke.

IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2024-08-06 DOI:10.1016/j.jocmr.2024.101076

Jun Zhang, Song Luo, Li Qi, Shutian Xu, Dongna Yi, Yue Jiang, Xiang Kong, Tongyuan Liu, Weiqiang Dou, Jun Cai, Long Jiang Zhang

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引用次数: 0

Abstract

Background: Exertional heatstroke (EHS) is increasingly common in young trained soldiers. However, prognostic markers in EHS patients remain unclear. The objective of this study was to evaluate cardiovascular magnetic resonance (CMR) feature tracking derived left ventricle (LV) strain as a biomarker for return to training (RTT) in trained soldiers with EHS.

Methods: Trained soldiers (participants) with EHS underwent CMR cine sequences between June 2020 and August 2023. Two-dimensional (2D) LV strain parameters were derived. At 3 months after index CMR, the participants with persistent cardiac symptoms including chest pain, dyspnea, palpitations, syncope, and recurrent heat-related illness were defined as non-RTT. Multivariable logistic regression analysis was used to develop a predictive RTT model. The performance of different models was compared using the area under curve (AUC).

Results: A total of 80 participants (median age, 21 years; interquartile range (IQR), 20-23 years) and 27 health controls (median age, 21 years; IQR, 20-22 years) were prospectively included. Of the 77 participants, 32 had persistent cardiac symptoms and were not able to RTT at 3 months follow-up after experiencing EHS. The 2D global longitudinal strain (GLS) was significantly impaired in EHS participants compared to the healthy control group (-15.8 ± 1.7% vs -16.9 ± 1.2%, P = 0.001), which also showed significant statistical differences between participants with RTT and non-RTT (-15.0 ± 3.5% vs -16.5 ± 1.4%, P < 0.001). 2D-GLS (≤ -15.0%) (odds ratio, 1.53; 95% confidence interval: 1.08, 2.17; P = 0.016) was an independent predictor for RTT even after adjusting known risk factors. 2D-GLS provided incremental prognostic value over the clinical model and conventional CMR parameters model (AUCs: 0.72 vs 0.88, P = 0.013; 0.79 vs 0.88, P = 0.023; respectively).

Conclusion: Two-dimensional global longitudinal strain (≤ -15.0%) is an incremental prognostic CMR biomarker to predict RTT in soldiers suffering from EHS.

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心脏磁共振特征追踪衍生应变分析可预测劳累性中暑后恢复训练的情况

背景：在受过训练的年轻士兵中，劳累性中暑（EHS）越来越常见。然而，EHS 患者的预后标志仍不明确。目的：在一项前瞻性心脏磁共振成像队列研究中，评估心脏磁共振成像特征追踪（CMR-FT）得出的左心室（LV）应变作为EHS受训士兵重返训练（RTT）的生物标志物：2020年6月至2023年8月期间，受过训练的EHS士兵（参与者）接受了心脏磁共振成像序列检查。得出二维（2D）左心室应变参数。在指数CMR后3个月，有持续心脏症状（包括胸痛、呼吸困难、心悸、晕厥和反复发热相关疾病）的参与者被定义为非RTT。多变量逻辑回归分析用于建立预测 RTT 的模型。使用曲线下面积（AUC）比较了不同模型的性能：前瞻性纳入了 80 名参与者（中位年龄 21 岁；四分位数间距 (IQR) 20-23 岁）和 27 名健康对照者（中位年龄 21 岁；IQR 20-22 岁）。在 77 名参与者中，32 人（41.6%）有持续的心脏症状，在经历 EHS 后的 3 个月随访中无法进行 RTT。与健康对照组相比，EHS 参与者的二维全局纵向应变（GLS）明显受损（-15.81 ± 1.67% vs -16.93 ± 1.22%，P =.001），RTT 参与者与非 RTT 参与者之间也存在明显的统计学差异（-14.99 ± 3.54% vs -16.53 ± 1.43%，P 结论：二维全局纵向应变（≤ -15.00%）是预测劳累性中暑士兵恢复训练的一种增量预后CMR生物标志物。

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

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.