先天性心脏病胎儿心血管磁共振特征跟踪心肌应变分析

IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2024-09-13 DOI:10.1016/j.jocmr.2024.101094

Thomas M Vollbrecht, Christopher Hart, Christoph Katemann, Alexander Isaak, Claus C Pieper, Daniel Kuetting, Ulrike Attenberger, Annegret Geipel, Brigitte Strizek, Julian A Luetkens

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引用次数: 0

摘要

背景：心血管磁共振（CMR）是评估先天性心脏病（CHD）胎儿心脏解剖和功能的新兴成像模式。本研究旨在利用胎儿 CMR 特征追踪（FT）评估不同亚型 CHD 的心肌应变：胎儿 CMR FT 分析是在 3 特斯拉多普勒 US 门控下采集的四腔 cine 图像上进行的回顾性分析。使用专为胎儿应变分析优化的软件对左心室（LV）整体纵向应变（GLS）、左心室整体径向应变（GRS）、左心室整体纵向收缩应变率（SR）和右心室（RV）GLS进行量化。对正常胎儿和不同 CHD 亚型（大动脉横位（dTGA）、左心房发育不全综合征（HLHS）、主动脉共动脉症（CoA）、法洛氏四联症（TOF）、RV 主导型房室间隔缺损（AVSD）和临界肺动脉狭窄或闭锁（PS/PA））的胎儿进行了分析。采用方差分析（ANOVA）和Tukey事后检验进行组间比较：共分析了 60 个胎儿（8/60（13%）无心脏缺损，52/60（87%）有心脏缺损）。成功评估了113/120个心室（94%）的心肌应变。与对照组相比，HLHS 胎儿的左心室 GLS 明显降低（-18.6±2.7% vs. -6.2±5.6%；p 结论：用CMR FT评估先天性心脏病胎儿心肌应变是可行的。不同类型的先天性心脏病之间存在明显差异，这对胎儿先天性心脏病的临床决策和预后判断具有潜在意义。

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Fetal cardiovascular magnetic resonance feature tracking myocardial strain analysis in congenital heart disease.

Background: Cardiovascular magnetic resonance (CMR) is an emerging imaging modality for assessing the anatomy and function of the fetal heart in congenital heart disease (CHD). This study aimed to evaluate myocardial strain using fetal CMR feature tracking (FT) in different subtypes of CHD.

Methods: Fetal CMR FT analysis was retrospectively performed on four-chamber cine images acquired with Doppler ultrasound gating at 3T. Left ventricular (LV) global longitudinal strain (GLS), LV global radial strain (GRS), LV global longitudinal systolic strain rate, and right ventricular (RV) GLS were quantified using dedicated software optimized for fetal strain analysis. Analysis was performed in normal fetuses and different CHD subtypes (d-transposition of the great arteries [dTGA], hypoplastic left heart syndrome [HLHS], coarctation of the aorta [CoA], tetralogy of Fallot [TOF], RV-dominant atrioventricular septal defect [AVSD], and critical pulmonary stenosis or atresia [PS/PA]). Analysis of variance with Tukey post-hoc test was used for group comparisons.

Results: A total of 60 fetuses were analyzed (8/60 (13%) without CHD, 52/60 (87%) with CHD). Myocardial strain was successfully assessed in 113/120 ventricles (94%). Compared to controls, LV GLS was significantly reduced in fetuses with HLHS (-18.6±2.7% vs -6.2±5.6%; p<0.001) and RV-dominant AVSD (-18.6±2.7% vs -7.7±5.0%; p = 0.003) and higher in fetuses with CoA (-18.6±2.7% vs -25.0±4.3%; p = 0.038). LV GRS was significantly reduced in fetuses with HLHS (25.7±7.5% vs 11.4±9.7%; p = 0.024). Compared to controls, RV GRS was significantly reduced in fetuses with PS/PA (-16.1±2.8% vs -8.3±4.2%; p = 0.007). Across all strain parameters, no significant differences were present between controls and fetuses diagnosed with dTGA and TOF.

Conclusion: Fetal myocardial strain assessment with CMR FT in CHD is feasible. Distinct differences are present between various types of CHD, suggesting potential implications for clinical decision-making and prognostication in fetal CHD.

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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.