Jakub Nowak, Maksym Sikora, Michał Drabik, Maria Kurek, Ewa Wieczorek-Surdacka, Bernadeta Chyrchel, Tadeusz Popiela
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There were no significant relations between ECVF and clinical or echocardiographic parameters. LV function was comparable according to median ECVF (24.7%) (S': 10.4 ± 4.1 vs. 9.5 ± 8.0 cm/s; E': 9.2 ± 3.4 vs. 9.4 ± 3.1 cm/s; E'/A' ratio: 1.0 ± 0.6 vs. 1.2 ± 0.9; E/E' ratio: 9.0 ± 4.8 vs. 9.4 ± 5.8 for ECVF above and below the median, respectively). S' and E' were positively correlated in 52 subjects with an over-median ECVF (r = 0.46, p = 0.001), in contrast to their 51 counterparts with a below-median ECVF (r = 0.15, p = 0.3). In conclusion, ECV expansion might be associated with a marked interdependence of S' and E', corresponding to systolic and early diastolic LV performance, respectively. As E' is a rough surrogate index of LV active relaxation, these findings could reflect a contribution of LV fibrosis to early LV diastolic dysfunction, known to coincide with discrete LV long-axis systolic dysfunction. Further studies are warranted to investigate relations between CT-derived ECVF and LV mechanics.</p>","PeriodicalId":12106,"journal":{"name":"Folia medica Cracoviensia","volume":"64 3","pages":"129-135"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Computed tomography-derived myocardial extracellular volume fraction - a redundant by-product or a novel promising marker?\",\"authors\":\"Jakub Nowak, Maksym Sikora, Michał Drabik, Maria Kurek, Ewa Wieczorek-Surdacka, Bernadeta Chyrchel, Tadeusz Popiela\",\"doi\":\"10.24425/fmc.2024.152173\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Myocardial extracellular volume (ECV) expansion is associated with myocardial abnormalities such as interstitial fibrosis, inflammation or amyloid deposition. Our aim was to search for correlates of ECV fraction (ECVF) derived from routine cardiac computed tomography (CT) of real-world patients. We retrospectively derived ECVF from archived chest CT scans performed in 103 patients (51 women and 52 men; mean age: 66 ± 13 years) during a diagnostic work-up based on clinical indications. From recorded echocardiographic images, we calculated indices of left ventricular (LV) structure and function, including systolic (S') and diastolic (E' and A') mitral annular velocities. There were no significant relations between ECVF and clinical or echocardiographic parameters. LV function was comparable according to median ECVF (24.7%) (S': 10.4 ± 4.1 vs. 9.5 ± 8.0 cm/s; E': 9.2 ± 3.4 vs. 9.4 ± 3.1 cm/s; E'/A' ratio: 1.0 ± 0.6 vs. 1.2 ± 0.9; E/E' ratio: 9.0 ± 4.8 vs. 9.4 ± 5.8 for ECVF above and below the median, respectively). S' and E' were positively correlated in 52 subjects with an over-median ECVF (r = 0.46, p = 0.001), in contrast to their 51 counterparts with a below-median ECVF (r = 0.15, p = 0.3). In conclusion, ECV expansion might be associated with a marked interdependence of S' and E', corresponding to systolic and early diastolic LV performance, respectively. As E' is a rough surrogate index of LV active relaxation, these findings could reflect a contribution of LV fibrosis to early LV diastolic dysfunction, known to coincide with discrete LV long-axis systolic dysfunction. 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引用次数: 0
摘要
心肌细胞外体积(ECV)扩张与心肌异常有关,如间质纤维化、炎症或淀粉样蛋白沉积。我们的目的是寻找来自真实世界患者的常规心脏计算机断层扫描(CT)的ECV分数(ECVF)的相关因素。我们回顾性地从103例患者(51名女性和52名男性;平均年龄:66±13岁)根据临床适应症进行诊断检查。根据记录的超声心动图图像,我们计算左心室(LV)结构和功能指标,包括收缩期(S′)和舒张期(E′和A′)二尖瓣环速度。ECVF与临床及超声心动图参数无明显关系。根据中位ECVF(24.7%),左室功能具有可比性(S': 10.4±4.1 vs. 9.5±8.0 cm/ S;E′:9.2±3.4 vs. 9.4±3.1 cm/s;E′/A′比值:1.0±0.6 vs. 1.2±0.9;E/E′比值:ECVF高于中位数和低于中位数的分别为9.0±4.8和9.4±5.8)。52名ECVF高于中位数的受试者的S′和E′呈正相关(r = 0.46, p = 0.001),而51名ECVF低于中位数的受试者的S′和E′呈正相关(r = 0.15, p = 0.3)。综上所述,ECV扩张可能与S‘和E’的显著相互依赖相关,分别对应于收缩期和舒张期早期的左室表现。由于E′是左室主动舒张的粗略替代指标,这些发现可能反映了左室纤维化对早期左室舒张功能障碍的贡献,已知与离散的左室长轴收缩功能障碍相吻合。进一步研究ct衍生的ECVF和左室力学之间的关系是必要的。
Computed tomography-derived myocardial extracellular volume fraction - a redundant by-product or a novel promising marker?
Myocardial extracellular volume (ECV) expansion is associated with myocardial abnormalities such as interstitial fibrosis, inflammation or amyloid deposition. Our aim was to search for correlates of ECV fraction (ECVF) derived from routine cardiac computed tomography (CT) of real-world patients. We retrospectively derived ECVF from archived chest CT scans performed in 103 patients (51 women and 52 men; mean age: 66 ± 13 years) during a diagnostic work-up based on clinical indications. From recorded echocardiographic images, we calculated indices of left ventricular (LV) structure and function, including systolic (S') and diastolic (E' and A') mitral annular velocities. There were no significant relations between ECVF and clinical or echocardiographic parameters. LV function was comparable according to median ECVF (24.7%) (S': 10.4 ± 4.1 vs. 9.5 ± 8.0 cm/s; E': 9.2 ± 3.4 vs. 9.4 ± 3.1 cm/s; E'/A' ratio: 1.0 ± 0.6 vs. 1.2 ± 0.9; E/E' ratio: 9.0 ± 4.8 vs. 9.4 ± 5.8 for ECVF above and below the median, respectively). S' and E' were positively correlated in 52 subjects with an over-median ECVF (r = 0.46, p = 0.001), in contrast to their 51 counterparts with a below-median ECVF (r = 0.15, p = 0.3). In conclusion, ECV expansion might be associated with a marked interdependence of S' and E', corresponding to systolic and early diastolic LV performance, respectively. As E' is a rough surrogate index of LV active relaxation, these findings could reflect a contribution of LV fibrosis to early LV diastolic dysfunction, known to coincide with discrete LV long-axis systolic dysfunction. Further studies are warranted to investigate relations between CT-derived ECVF and LV mechanics.