Shing Ching, Jeffrey Ji-Peng Li, Stefanie Maria Werhahn, Rebecca Elisabeth Beyer, Misael Estepa, Christian Stehning, Djawid Hashemi, Natalia Solowjowa, Christoph Klein, Henryk Dreger, Sebastian Kelle, Patrick Doeblin
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引用次数: 0
Abstract
Background: While left-bundle-branch-block-related contraction patterns as well as echocardiography-derived strain are variably associated with the volumetric response to cardiac resynchronization therapy (CRT), the role of CMR-derived strain parameters is unexplored.
Methods: A total of 50 patients receiving CRT implantation were retrospectively analyzed, all of whom had undergone CMR imaging within one year before, and echocardiography within 6 months before and 6-12 months after CRT implantation. We assessed CMR-derived morphological and functional parameters with regard to the echocardiographic response, defined as a reduction in the left ventricular end-systolic volume of ≥15%.
Results: Among the standard CMR parameters, the indexed right ventricular volumes in end-diastole (RVEDVi) (74.5 ± 19.5 vs. 94.8 ± 30.2 mL/m2, p = 0.006) and end-systole (RVESVi) (43.2 ± 13.3 vs. 61.6 ± 28.8 mL/m2, p = 0.003), as well as the left atrial (LA) area (24.8 ± 3.5 vs. 30.4 ± 9.5 cm2, p = 0.020), differed significantly between CRT responders and non-responders. In strain analysis, CRT responders showed a significantly better LA global longitudinal strain (GLS) (25.1 ± 10.4 vs. 15.3 ± 10.5, p = 0.002), LA global circumferential strain (GCS) (27.9 ± 14.7 vs. 17.1 ± 13.1%, p = 0.012), RV GLS (-25.0 ± 6.5 vs. -18.9 ± 7.6%, p = 0.004) and RV free wall strain (-31.1 ± 7.9 vs. -24.9 ± 9.5, p = 0.017).
Conclusions: CMR-derived peak septal circumferential strain and RVEDVi correlated with the echocardiographic volumetric response to CRT at 6-12 months.
背景：虽然左束-分支阻滞相关的收缩模式以及超声心动图衍生的应变与心脏再同步化治疗（CRT）的容积反应有不同的相关性，但cmr衍生的应变参数的作用尚未得到探讨。方法：回顾性分析50例接受CRT植入的患者，均在植入前1年内行CMR成像，在植入前6个月及植入后6-12个月行超声心动图检查。我们评估了cmr衍生的超声心动图反应的形态学和功能参数，定义为左心室收缩末期容积减少≥15%。结果：在标准CMR参数中，舒张末期右心室容积（RVEDVi）（74.5±19.5 vs. 94.8±30.2 mL/m2, p = 0.006）、收缩期末期（RVESVi）（43.2±13.3 vs. 61.6±28.8 mL/m2, p = 0.003）和左心房面积（24.8±3.5 vs. 30.4±9.5 cm2, p = 0.020）在CRT应答者和无应答者之间差异有统计学意义。在应变分析中，CRT应答者表现出较好的LA整体纵向应变（GLS）（25.1±10.4比15.3±10.5,p = 0.002）、LA整体周向应变（GCS）（27.9±14.7比17.1±13.1%,p = 0.012）、RV整体GLS（-25.0±6.5比-18.9±7.6%,p = 0.004）和RV游离壁应变（-31.1±7.9比-24.9±9.5,p = 0.017）。结论：cmr衍生的间隔周应变峰值和RVEDVi与6-12个月时对CRT的超声心动图容量反应相关。
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