Quantitative Cardiac Magnetic Resonance Imaging Techniques In The Assesment Of Patients With Early Stage Hypertensive Heart Disease

Purpose The aim of this study was to assess the left ventricular myocardial diffuse fibrosis and subclinical myocardial dysfunction in patients with early stage hypertensive heart disease（HHD）by cardiac magnetic resonance（CMR）T1 mapping and feature tracking（CMR-FT）techniques.Methods 46 HHD patients and 30 age-and gender-matched normotensive controls were consecutively enrolled and underwent 3.0T CMR examinations.According to the presence of left ventricular hypertrophy（LVH）,HHD patients were divided into HHD-LVH group and HHD-non LVH group.We measured cardiac function variables,T1 mapping parameters and myocardial strain indices by Argus and CVI⁴² post-processing software.Continuous variables were analyzed using independent sample t test or Mann-Whitney U test between two groups.One-way analysis of variance with scheffe correction or Kruskal-Wallis test were performed for multiple comparisons.Univariable and multivariable linear regression models were determined relationships between T1mapping parameters,strain indices and related factors.Receiver operating characteristic（ROC） curve analysis was performed to determine the diagnostic ability of quantitative parameters for differentiation of HHD patients with controls.Results Compared with controls,LVMI,LVMWT and M/V were increased,native T1 was prolonged,ECV was increased,GRS,GCS,GLS,DRSR_peak,DCSR_peak and DLSR_peakwere significantly impaired in HHD group（all p<0.05）.In subgroup analysis,LVMI,LVMWT and M/V were increased and GLS was decreased in HHD-LVH group than those in HHD-non LVH group and control group,native T1 and ECV were higher in HHD-LVH patients than those in controls（all p<0.05）.Multivariable linear regression analysis showed that GRS and GCS were negatively correlated with LVEDVI(β=-0.437,p=0.006,R²_adj=0.428;β=0.459,p=0.011,R²_adj=0.246),GLS was negatively associated with LVMWT(β=0.575,p=0.004,R²_adj=0.375).ROC analysis showed that ECV had the best performance to discriminate HHD patients（AUC=0.879）with 76.3%sensitivity and 84%specificity.Conclusion native T1 and ECV were increased and strain indices were impaired in HHD patients.CMR T1 mapping and CMR-FT techniques could allow early detection of left ventricular myocardial diffuse fibrosis and subclinical myocardial dysfunction in HHD patients.