| Objective: The purpose of this study was to investigate the feasibility of noninvasive quantitative evaluation of biventricular myocardial strain parameters differences between myocardial amyloidosis（CA）and other left ventricular hypertrophic diseases（LVH）by cardiac magnetic resonance tissue tracking（CMR-TT）.Materials and methods: the clinical baseline data of 15 patients with cardiac amyloidosis（CA）,44 patients with hypertrophic cardiomyopathy（HCM）,30 patients with hypertensive heart disease（HHD）and 30 healthy volunteers（NC）who underwent CMR examination in the first Hospital of Lanzhou University from January 2018 to September 2021 were retrospectively included.The global and local longitudinal strain（LS）,radial strain（RS）,circumferential strain（CS）,gradient difference from base to apex of LS,plane systolic displacement of mitral annulus（MAPSE）,plane systolic displacement of tricuspid annulus（TAPSE）and other cardiac function parameters were obtained by CVI postprocessing software.The differences of parameters between groups and within groups were analyzed by SPSS 28.0 statistical software.Pearson and Spearman correlation tests were used to evaluate the correlation between ejection fraction and bicompartment global strain parameters.Univariate logistic regression was used to explore the correlation between global myocardial strain parameters of biventricle and CA,HCM and HHD.Receiver operating characteristic（ROC）curve was used to evaluate the sensitivity and specificity of biventricular global myocardial strain parameters in the diagnosis of CA and HCM.Results:（1）the New York heart function grade of CA patients was worse than that of the other three groups [（2.6 ±0.6）vs.（2.4 ±0.5）vs.（2.2 ±0.7）,P < 0.05].（2）all CMR cardiac function parameters were statistically significant among the four groups（P < 0.05）.（3）there were significant differences in global and local LS,RS and CS of left and right ventricles among the four groups,in which the absolute values of all strain parameters in CA group were lower than those in the other three groups,except LS in the middle segment of right ventricle and RS in apical segment,the absolute values of other strain parameters in HCM group were higher than those in HHD group and CA group.（4）the gradient difference of left and right ventricular LS from basal segment to apical segment was statistically significant among the four groups.The gradient difference of biventricular LS in CA group was the largest.The gradient difference from basal segment to apical segment of left ventricular LS in CA group was larger than that in HCM group,HHD group and NC group [（5.3 ±2.1）% vs.（3.12 ±2.47）% vs.（4.3 ±2.2）% vs.The gradient difference of right ventricular LS from basal segment to apical segment in CA group was larger than that in HCM group,HHD group and NC group.（5）there was significant difference in the correlation between ejection fraction and biventricular global myocardial strain parameters in CA,HCM,HHD and NC groups.（6）LVEF,RVEF,MAPSE,TAPSE,LVGLS,LVGCS,LVGRS,RVGLS,RVGCS,RVGRS are important indexes to distinguish CA group from HCM group,LVGLS is important index to distinguish CA group from HHD group,RVEF,LVGLS,LVGCS,LVGRS,RVGLS,RVGCS and RVGRS are important indexes to distinguish HCM group from HHD group.（7）when LVGLS absolute value < 10.9%,LVGCS absolute value < 14.0%,RVGLS absolute value < 17.1% and RVGCS absolute value <11.0%,CA can be distinguished from other left ventricular hypertrophic diseases;when MAPSE > 9.3mm,LVGRS > 16.7% and RVGRS > 18.1%,HCM can be distinguished from other left ventricular hypertrophic diseases.Conclusion: CMR-TT technique can be used to quantitatively analyze the global and regional myocardial strain of left and right ventricles in patients with CA,HCM and HHD.The absolute values of myocardial strain parameters of left and right ventricles in patients with CA decrease more significantly.Biventricular LS apical retention model is helpful to distinguish CA from other left ventricular hypertrophic diseases. |
PDF Full Text Request