Zixian Chen, Yue Sun, Na Yang, Jiang Nan, Likun Cao, Lei Zhao, Shengliang Liu, Jizhe Xu, Yuxi Li, Xiangui He, Yi Wu, Jian Gao, Zixuan Chen, Liang Cao, Yaping Zhang, Yanyu Li, Qi Xu, Shu Jiang, Jian Cao, Fangying Wei, Xiaojie Mao, Zhuoli Zhang, Yining Wang, Junqiang Lei
{"title":"高海拔，更深入的洞察：肥厚性心肌病的多中心心血管磁共振研究。","authors":"Zixian Chen, Yue Sun, Na Yang, Jiang Nan, Likun Cao, Lei Zhao, Shengliang Liu, Jizhe Xu, Yuxi Li, Xiangui He, Yi Wu, Jian Gao, Zixuan Chen, Liang Cao, Yaping Zhang, Yanyu Li, Qi Xu, Shu Jiang, Jian Cao, Fangying Wei, Xiaojie Mao, Zhuoli Zhang, Yining Wang, Junqiang Lei","doi":"10.1007/s00330-024-11305-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Altitude is a known factor in cardiovascular disease, but its impact on hypertrophic cardiomyopathy (HCM) patients remains unclear. This study aimed to determine whether living at high altitudes affects the extent of late gadolinium enhancement (LGE) and left ventricular (LV) strain in HCM patients.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was conducted across four hospitals located at different altitudes in China. A total of 256 HCM patients who underwent cardiac magnetic resonance (CMR) imaging between May 2019 and November 2021 were included. Patients were categorized into two groups: the high-altitude group (median interquartile range [IQR]: 1520.00 [1520.00, 1917.00] meters, n = 132) and the low-altitude group (86.45 [43.50, 150.75] meters, n = 124). The extent of LGE and global LV strain were assessed and compared between these groups.</p><p><strong>Results: </strong>The median age of the study population was 55 years (IQR: 46-63), with 59% of participants being male. The high-altitude group exhibited a significantly greater extent of LGE compared to the low-altitude group (median [IQR]: 8.10 [4.78, 19.98]% vs. 6.20 [1.89, 13.81]%; p = 0.008). Multivariable analysis identified altitude as an independent predictor of increased LGE extent (β = 4.41; 95% CI: 2.04 to 6.78; p < 0.001). Additionally, altitude was positively associated with LV strain in the longitudinal, circumferential, and radial directions (all p < 0.050).</p><p><strong>Conclusion: </strong>HCM patients living at higher altitudes exhibit a significant increase in LGE extent and more favorable LV strain parameters.</p><p><strong>Key points: </strong>Question Does altitude affect the extent of late gadolinium enhancement (LGE) and left ventricular strain in patients with hypertrophic cardiomyopathy (HCM)? Findings High altitude is associated with a significantly greater extent of LGE and less impairment in global longitudinal strain in HCM patients. Clinical relevance HCM patients living at higher altitudes exhibit a significant increase in LGE extent and the mismatch of left ventricular strains. Doctors should consider these findings to tailor treatment and follow-up plans for HCM patients living in high altitudes.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"3883-3894"},"PeriodicalIF":4.7000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"High altitudes, deeper insights: multicenter cardiovascular magnetic resonance study on hypertrophic cardiomyopathy.\",\"authors\":\"Zixian Chen, Yue Sun, Na Yang, Jiang Nan, Likun Cao, Lei Zhao, Shengliang Liu, Jizhe Xu, Yuxi Li, Xiangui He, Yi Wu, Jian Gao, Zixuan Chen, Liang Cao, Yaping Zhang, Yanyu Li, Qi Xu, Shu Jiang, Jian Cao, Fangying Wei, Xiaojie Mao, Zhuoli Zhang, Yining Wang, Junqiang Lei\",\"doi\":\"10.1007/s00330-024-11305-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>Altitude is a known factor in cardiovascular disease, but its impact on hypertrophic cardiomyopathy (HCM) patients remains unclear. This study aimed to determine whether living at high altitudes affects the extent of late gadolinium enhancement (LGE) and left ventricular (LV) strain in HCM patients.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was conducted across four hospitals located at different altitudes in China. A total of 256 HCM patients who underwent cardiac magnetic resonance (CMR) imaging between May 2019 and November 2021 were included. Patients were categorized into two groups: the high-altitude group (median interquartile range [IQR]: 1520.00 [1520.00, 1917.00] meters, n = 132) and the low-altitude group (86.45 [43.50, 150.75] meters, n = 124). The extent of LGE and global LV strain were assessed and compared between these groups.</p><p><strong>Results: </strong>The median age of the study population was 55 years (IQR: 46-63), with 59% of participants being male. The high-altitude group exhibited a significantly greater extent of LGE compared to the low-altitude group (median [IQR]: 8.10 [4.78, 19.98]% vs. 6.20 [1.89, 13.81]%; p = 0.008). Multivariable analysis identified altitude as an independent predictor of increased LGE extent (β = 4.41; 95% CI: 2.04 to 6.78; p < 0.001). Additionally, altitude was positively associated with LV strain in the longitudinal, circumferential, and radial directions (all p < 0.050).</p><p><strong>Conclusion: </strong>HCM patients living at higher altitudes exhibit a significant increase in LGE extent and more favorable LV strain parameters.</p><p><strong>Key points: </strong>Question Does altitude affect the extent of late gadolinium enhancement (LGE) and left ventricular strain in patients with hypertrophic cardiomyopathy (HCM)? Findings High altitude is associated with a significantly greater extent of LGE and less impairment in global longitudinal strain in HCM patients. Clinical relevance HCM patients living at higher altitudes exhibit a significant increase in LGE extent and the mismatch of left ventricular strains. Doctors should consider these findings to tailor treatment and follow-up plans for HCM patients living in high altitudes.</p>\",\"PeriodicalId\":12076,\"journal\":{\"name\":\"European Radiology\",\"volume\":\" \",\"pages\":\"3883-3894\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00330-024-11305-2\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/31 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00330-024-11305-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/31 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
目的：海拔高度是心血管疾病的一个已知因素，但其对肥厚性心肌病（HCM）患者的影响尚不清楚。本研究旨在确定生活在高海拔地区是否会影响HCM患者晚期钆增强（LGE）和左心室（LV）应变的程度。方法：对中国不同海拔地区的四家医院进行回顾性横断面研究。共纳入了2019年5月至2021年11月期间接受心脏磁共振（CMR）成像的256例HCM患者。将患者分为两组：高海拔组（四分位数中位数范围[IQR]: 1520.00 [1520.00, 1917.00] m, n = 132）和低海拔组（86.45 [43.50,150.75]m, n = 124）。评估和比较各组间LGE程度和整体LV菌株。结果：研究人群的中位年龄为55岁（IQR: 46-63）， 59%的参与者为男性。高海拔组LGE程度显著高于低海拔组(中位[IQR]: 8.10 [4.78, 19.98]% vs. 6.20 [1.89, 13.81]%；p = 0.008)。多变量分析发现海拔是LGE程度增加的独立预测因子(β = 4.41；95% CI: 2.04 ~ 6.78；P < 0.001)。海拔高度与纵向、周向和径向LV应变呈正相关（均p < 0.050）。结论：生活在高海拔地区的HCM患者LGE程度明显增加，左室应变参数更有利。海拔是否影响肥厚性心肌病（HCM）患者晚期钆增强（LGE）程度和左心室劳损？研究发现，高海拔与HCM患者的LGE程度显著增加和整体纵向应变损伤较小相关。生活在高海拔地区的HCM患者LGE程度明显增加，左心室应变不匹配。医生应考虑这些发现，为生活在高海拔地区的HCM患者量身定制治疗和随访计划。
High altitudes, deeper insights: multicenter cardiovascular magnetic resonance study on hypertrophic cardiomyopathy.
Objectives: Altitude is a known factor in cardiovascular disease, but its impact on hypertrophic cardiomyopathy (HCM) patients remains unclear. This study aimed to determine whether living at high altitudes affects the extent of late gadolinium enhancement (LGE) and left ventricular (LV) strain in HCM patients.
Methods: This retrospective cross-sectional study was conducted across four hospitals located at different altitudes in China. A total of 256 HCM patients who underwent cardiac magnetic resonance (CMR) imaging between May 2019 and November 2021 were included. Patients were categorized into two groups: the high-altitude group (median interquartile range [IQR]: 1520.00 [1520.00, 1917.00] meters, n = 132) and the low-altitude group (86.45 [43.50, 150.75] meters, n = 124). The extent of LGE and global LV strain were assessed and compared between these groups.
Results: The median age of the study population was 55 years (IQR: 46-63), with 59% of participants being male. The high-altitude group exhibited a significantly greater extent of LGE compared to the low-altitude group (median [IQR]: 8.10 [4.78, 19.98]% vs. 6.20 [1.89, 13.81]%; p = 0.008). Multivariable analysis identified altitude as an independent predictor of increased LGE extent (β = 4.41; 95% CI: 2.04 to 6.78; p < 0.001). Additionally, altitude was positively associated with LV strain in the longitudinal, circumferential, and radial directions (all p < 0.050).
Conclusion: HCM patients living at higher altitudes exhibit a significant increase in LGE extent and more favorable LV strain parameters.
Key points: Question Does altitude affect the extent of late gadolinium enhancement (LGE) and left ventricular strain in patients with hypertrophic cardiomyopathy (HCM)? Findings High altitude is associated with a significantly greater extent of LGE and less impairment in global longitudinal strain in HCM patients. Clinical relevance HCM patients living at higher altitudes exhibit a significant increase in LGE extent and the mismatch of left ventricular strains. Doctors should consider these findings to tailor treatment and follow-up plans for HCM patients living in high altitudes.
期刊介绍：
European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field.
This is the Journal of the European Society of Radiology, and the official journal of a number of societies.
From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.
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