The Value Of 3.0T Magnetic Resonance Imaging In Evaluating The Right Heart Function In Hypertrophic Cardiomyopathy

Objective: To investigate the value of 3.0T magnetic resonance imaging in evaluating right ventricular function in hypertrophic cardiomyopathy.Methods: Eighty-seven patients were enrolled in XXXX from February 2013 to December 2018,whose clinical and Imaging diagnosis were hypertrophic cardiomyopathy(HCM).Including non-obstructive hypertrophic cardiomyopathy(HNCM)57 cases,obstructive hypertrophic cardiomyopathy(HOCM)30 cases.42 patients with hypertensive cardiomyopathy(HHD)and 42 patients with asymptomatic normal volunteers were collected.All patient images were imported into Cvi42 cardiac function analysis software,and three radiologists performed relevant data measurements to obtain the end-diastolic volume(EDV),end-systolic volume(ESV),Ejection Fraction(EF),Stroke Volume(SV),Cardiac Output(CO),Myocardial Mass(MM)of the left and right ventricles,The thickness of the interventricular septum(IVST).And semi-quantitative indicator were acquired,including tricuspid annular plane systolic excursion(TAPSE),right ventricular longitudinal axis shortening fraction(RVFS),right ventricular area change fraction(RVFAC),RV fractional mid-diameter change(FMDC).Differences between the two groups of data were compared using the independent t test.Spearman correlation analysis was performed between the semi-quantitative indicators of the right ventricle and RVEF.RESULTS: The mean LVEF of HOCM patients was higher than that of HNCM and normal volunteers.The mean values of LV Mass and IVST in HOCM patients were significantly higher than those in normal volunteers,and there was no significant difference compared with HNCM group.The mean values of Semi-quantitative indexes TAPSE,RVFS,RVFAC,FMDC were significantly higher than those in the normal volunteer group,and the P values were <0.05,there is a significant difference between the two groups.The mean values of LV Mass and IVST in HNCM patients were significantly higher than those in normal volunteers,The mean values of RVEDV,RVSV and RVCO were lower than those in normal volunteers,The mean RV Mass was higher than that in normal volunteers,The mean values of semi-quantitative indexes RVFAC and FMDC were higher than those in normal volunteers,P values were <0.05,and there is a significant difference between the two groups.Compared with HNCM patients,the mean values of TAPSE,RVFS and FMDC in HOCM patients were higher than those in HNCM patients,there is a significant difference between the two groups.There was no significant difference in the mean values of other cardiac function indexes.The mean values of LVEF and IVST in HCM patients were higher than those in HHD group and normal volunteer group,P value was <0.05,the statistical difference was significant.The mean value of LV Mass in HCM patients was significantly higher than that in normal volunteer group,P value was <0.05,the statistical difference was significant,and there was no significant difference compared with HHD groups.The mean value of LVESV,RVEDV and RVESV in HCM patients was lower than that of HHD and normal volunteers,and the mean values of semi-quantitative indexes RVFAC and FMDC were significantly higher than those of normal volunteers,P value was <0.05,the Statistical difference was significant.The mean values of LVEDV,LV Mass,IVST and RV Mass in the HHD patients were higher than those in the normal volunteer group,The semi-quantitative indexes TAPSE and RVFS in the HHD patients were lower than those in the normal volunteer group,and the P values were all <0.05,there is a significant difference between the two groups.The mean values of LVEDV,LVESV,RVEDV,RVESV and RV Mass in HHD patients were higher than those in HCM patients,the mean values of LVEF and IVST were lower than those in HCM patients,the mean values of semi-quantitative indexes TAPSE,RVFS and RVFAC were lower than those of HCM patients,P values were <0.05,the statistical difference is significant.The semi-quantitative index TAPSE of right ventricular function in the HCM patient group was weakly negatively correlated with IVST(r=-0.236,p=0.028).RVFS was negatively correlated with IVST(r=-0.317,p=0.003).RVFAC was low Positive correlated with RVEF(r=0.411,p=0.000),and weak positive correlated with IVST(r=0.291,p=0.006).FMDC was weak positive correlated with RVEF(r=0.225,p=0.036),low Positive correlated with IVST(r=0.337,p=0.001).RVEF had no correlation with IVST(r=0.203,p=0.059).The semi-quantitative index TAPSE of right ventricular function in patients with HHD was positively correlated with RVEF(r=0.448,p=0.003).RVFS was positively correlated with RVEF(r=0.554,p=0.000).RVFAC was significantly positively correlated with RVEF(r=0.674,p=0.000).FMDC was significantly positively correlated with RVEF(r=0.689,p=0.000).there was no correlation between semi-quantitative indicators and IVST.RVEF had no correlation with IVST(r=-0.050,p=0.752).Conclusion:CMR can comprehensively evaluate the left ventricular and right ventricular structural and function of patients with HCM,and provide reliable imaging protocols for clinically accurate treatment and comprehensive evaluation of disease and prognosis.The semi-quantitative index of right ventricle can reflect the early changes of right ventricular function in HCM.The longitudinal and horizontal axis contraction movements of HOCM are enhanced,the horizontal axis contraction movement of HNCM is enhanced,and the horizontal axis contraction movement of HOCM is more obvious than that of HNCM.The assessment of the thickness of the interventricular septum,right ventricular myocardial mass,and right ventricular longitudinal axis systolic function contributes to the differential diagnosis of HCM and HHD.