| Objective: The left ventricular function and prognostic value of DCM patients were evaluated by myocardial strain analysis based on Cine-MR images.Materials and methods:Between 2016 and 2017,32 patients with DCM and 20 healthy controls were examined by cardiac magnetic resonance imaging(MRI)sequence in the radiology department of our hospital.The diagnosis of DCM group was based on the diagnostic criteria of WHO dilated cardiomyopathy in 1995,that is,LVEDD > 55 mm and LVEF < 45%.Other diseases causing left ventricular systolic dysfunction and ventricular dilatation were excluded.In the healthy control group,echocardiography and electrocardiogram were required to be normal,and there was no family history of cardiovascular disease.1.The cardiac function parameters LVEDV,LVESV,LVEF,SV and LV mass were measured by CVI42 software.The global and segmental strains of left ventricular myocardium in DCM group and healthy control group(divided according to(AHA)16 segmental model of American Heart Association)were analyzed by tissue tracking program,and GRS,GCS,GLS,CS and RS were obtained respectively.The differences of cardiac function parameters and strain parameters between the two groups were compared.The correlation between GLS,GRS,GCS and LVEF in DCM group was analyzed by pearson.2.Cases and telephone follow-up were carried out on the subjects hospitalized in the Department of congenital Heart Disease of our hospital in the DCM group.the successful follow-up information was included in the experiment,a total of 29 cases.We divided the subjects into two groups: good prognosis(n =17)and poor prognosis(n = 12).The detailed clinical data of the two groups were collected,and the clinical information,cardiac function parameters and overall strain values of the two groups were compared and analyzed.based on the results of univariate analysis,all the parameters of P < 0.01 were included in the binary Logistic multivariate regression analysis.Results:1.the cardiac function parameters LVEDV and LVESV in DCM group were higher than those in healthy control group(P < 0.001);LVEF,SV were lower than those in control group,the difference was statistically significant(P < 0.001).The strain parameters of left ventricular GRS,GCS and GLS in DCM group were significantly lower than those in control group(P < 0.001).In segmental strain analysis,the PRS of each segment of DCM was lower than that of the control group,and the difference was statistically significant(P < 0.001).There was no significant difference in PCS between DCM group and control group(P > 0.05),but PCS in other DCM group was lower than that in control group(P < 0.05).Analysis of the correlation between GLS,GCS,GRS and LVEF in DCM Group;GLS,GCS,GRS(r ? 0.903,0.895,0.869)in DCM group were highly correlated with LVEF(P < 0.869).2.univariate analysis showed that there was no significant difference in age,sex,smoking,hypertension,diabetes,hyperlipidemia,atrial fibrillation,SV and GRS between the better prognosis group and the poor prognosis group(P > 0.05).The value of NT-pro BNP in patients with poor short-term prognosis was significantly higher than that in patients with good short-term prognosis(P < 0.05).The levels of LVEDV,LVESV,LVEF and GCS in the group with better prognosis were better than those in the group with poor prognosis(P < 0.05).The value of LV mass in the patients with poor prognosis was significantly higher than that in the patients with good short-term prognosis(P < 0.01).The GLS value of the patients with poor prognosis was lower than that of the patients with good short-term prognosis,and the difference was statistically significant(P < 0.01).Binary Logistic regression analysis showed that GLS was related to the deterioration of patients with dilated cardiomyopathy within one year of optimal drug treatment,and the difference was statistically significant(OR=2.233,P < 0.05).Conclusion: 1.Myocardial strain analysis based on Cine-MR(cine magnetic resonance,(Magnetic Resonance Cardiac Cinema)images can detect abnormal myocardial motion in patients with dilated cardiomyopathy(DCM).2.The overall longitudinal strain derived from magnetic resonance tissue tracking technique can be used as an independent predictor of deterioration in patients with dilated cardiomyopathy after standard drug treatment within one year. |
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