Quantitative comparison of two-dimensional and three-dimensional strain measurement using MRI feature tracking in repair Fontan patients and normal child volunteers.
- 作者列表："Hu L","Wang Q","Gregory BP","Ouyang RZ","Sun A","Guo C","Han T","Zhong Y
BACKGROUND:The accuracy of 2D and 3D strain analyses was evaluated by comparing strain and cardiac function parameters in Fontan repair patients and normal child volunteers. METHODS:We retrospectively enrolled 32 patients with Fontan circulation and 32 child volunteers who had undergone clinical cardiac magnetic resonance (CMR) assessment of the dominant ventricle with a 1.5-Tesla MRI scanner. Global and regional strain (2D and 3D) of the dominant ventricle in both groups was assessed using CMR feature-tracking. Correlations between cardiac function and strain data were assessed using Pearson's correlation coefficient values. The intraclass correlation coefficient (ICC) and coefficient of variation (CoV) were determined to evaluate repeatability and agreement. RESULTS:The 2D GLS showed significant differences between the Fontan repair patients and volunteers (- 16.49 ± 5.00 vs. -19.49 ± 2.03; p = 0.002). The 2D GRS and 2D GCS showed no significant differences between two groups. 2D GRS: 38.96 ± 14.48 vs. 37.46 ± 7.77; 2D GCS: - 17.64 ± 5.00 vs. -16.89 ± 2.96, respectively; p > 0.05). The 3D global radial strain (GRS), global circumferential strain (GCS), and global longitudinal strain (GLS) showed significant differences between the Fontan repair patients and volunteers (3D GRS: 36.35 ± 16.72 vs. 44.96 ± 9.98; 3D GLS: - 8.86 ± 6.84 vs. -13.67 ± 2.44; 3D GCS: - 13.70 ± 7.84 vs. -18.01 ± 1.78; p < 0.05, respectively). The ejection fraction (EF) and 3D GCS were significantly associated (r = - 0.491, p = 0.004). The 3D GCS showed correlations with the indexed end-diastolic volume (EDV) (r = 0.523, p = 0.002) and indexed end-systolic volume (ESV) (r = 0.602, p < 0.001). 3D strain showed good reproducibility, with GCS showing the best inter-observer agreement (ICC = 0.87 and CoV = 5.15), followed by GLS (ICC = 0.84 and CoV = 5.36). CONCLUSIONS:3D GCS is feasible, highly reproducible, and strongly correlated with conventional cardiac function measures. 3D GCS assessments may be useful for monitoring abnormal myocardial motion in patients with Fontan circulation.
背景: 通过比较Fontan修复患者和正常儿童志愿者的应变和心功能参数，评估2D和3D应变分析的准确性。 方法: 我们回顾性纳入了32例Fontan循环患者和32名儿童志愿者，他们用1.5特斯拉MRI扫描仪对优势心室进行了临床心脏磁共振 (CMR) 评估。使用CMR特征跟踪评估两组中优势心室的整体和区域应变 (2D和3D)。使用Pearson相关系数值评估心脏功能和应变数据之间的相关性。测定组内相关系数 (ICC) 和变异系数 (CoV) 以评价重复性和一致性。 结果: 2D GLS显示Fontan修复患者和志愿者之间存在显著差异 (-16.49 5.00 ± 19.49 vs. -2.03 ± 0.002; P = )。2D GRS和2D GCS显示两组之间无显著差异。2D GRS: 38.96 ± 14.48对37.46 ± 7.77; 2D GCS: -17.64 ± 5.00对-16.89 ± 2.96; P> 0.05)。3D整体径向应变 (GRS) 、整体周向应变 (GCS) 和整体纵向应变 (GLS) 显示Fontan修复患者和志愿者之间存在显著差异 (3D GRS: 36.35 ± 16.72 vs. 44.96 ± 9.98 8.86; 3D GLS: - 6.84 ± vs. -13.67 ± 2.44; 3D GCS: -13.70 ± 7.84 vs. -18.01 ± 1.78; P <0.05)。射血分数 (EF) 与3D GCS显著相关 (r = - 0.491，p = 0.004)。3D GCS显示与指数舒张末期容积 (EDV) (r = 0.523，p = 0.002) 和指数收缩末期容积 (ESV) (r = 0.602 0.001，p < ) 的相关性。3D应变显示良好的再现性，GCS显示最佳的观察者间一致性 (icc = 0.87，cov = 5.15)，其次是GLS (icc = 0.84，cov = 5.36)。 结论: 3D GCS是可行的，具有高度的可重复性，并且与常规的心脏功能测量密切相关。3D GCS评估可用于监测Fontan循环患者的异常心肌运动。
METHODS::We present the case of a 61-year-old woman with a large tumoral infiltration extending from the pelvis throughout the inferior vena cava inferior to the right atrium, protruding into the right ventricle and right ventricular outflow tract. She had been treated 10 years before for low-grade endometrial stromal sarcoma by hysterectomy and adnexectomy followed by hormone- and radio-therapy. Due to cancer recurrence, she underwent peritonectomy, appendectomy, and resection of terminal ileum.
METHODS:AIMS:Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. METHODS AND RESULTS:Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. CONCLUSIONS:In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.
METHODS:BACKGROUND:Aortopulmonary window is an uncommon congenital heart disease, with untreated cases not surviving beyond childhood. However, very rarely it can present in adult patients with features of pulmonary hypertension. Clinically these patients cannot be differentiated from other more common conditions with left to right shunt. Transthoracic echocardiography if performed meticulously, can depict the defect in aortopulmonary septum. RESULTS:We report a case of large unrepaired aortopulmonary window in a 23 years old patient, diagnosed on transthoracic echocardiography.