Tỷ lệ thời gian thư giãn T2 của máu từ tâm thất phải đến tâm thất trái dựa trên MRI tim tương quan với khả năng vận động ở bệnh nhân suy tim mãn tính

Journal of Cardiovascular Magnetic Resonance - Tập 25 - Trang 1-12 - 2023
Moritz C. Halfmann1,2, Lukas Müller1, Urs von Henning3, Roman Kloeckner1,4, Theresia Schöler1, Karl-Friedrich Kreitner1, Christoph Düber1, Philip Wenzel5,3, Akos Varga-Szemes6, Sebastian Göbel3,7, Tilman Emrich1,5
1Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
2German Center for Cardiovascular Research (DZHK), Partner Site Rhine‐Main, Mainz, Germany
3Department of Cardiology, University Medical Center Mainz-Center of Cardiology, Johannes Gutenberg University, Mainz, Germany
4Department for Interventional Radiology, University Hospital of Lübeck, Lübeck, Germany
5German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
6Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, USA
7Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany

Tóm tắt

Thăm dò T2 bằng MRI đã được chứng minh là nhạy cảm với mức độ oxy hóa trong máu. Chúng tôi đưa ra giả thuyết rằng khả năng vận động bị suy yếu trong suy tim mãn tính liên quan đến sự khác biệt lớn hơn giữa thời gian thư giãn T2 của bể máu tâm thất phải (RV) và tâm thất trái (LV) do mức độ khử oxy trong máu ngoại vi cao hơn, so với bệnh nhân có khả năng vận động bảo tồn và những người khỏe mạnh. Những bệnh nhân suy tim mãn tính (n = 70) đã được xác định theo cách hồi cứu, những người đã trải qua cả MRI tim (CMR) và bài kiểm tra đi bộ 6 phút (6MWT). Nhóm đối chứng là các cá nhân khỏe mạnh (n = 35) được ghép cặp theo điểm xu hướng. Phân tích CMR bao gồm việc thu thập hình ảnh cine và thăm dò T2 để thu được thời gian thư giãn T2 của bể máu ở RV và LV. Theo thực hành thông thường, các khoảng cách danh nghĩa đã được điều chỉnh theo tuổi và giới tính, cũng như các phân vị tương ứng đã được tính cho 6MWT. Mối quan hệ giữa tỷ lệ T2 bể máu RV/LV và kết quả từ 6MWT đã được đánh giá bằng hệ số tương quan Spearman và phân tích hồi quy. Các sự khác biệt giữa các nhóm đã được đánh giá bằng kiểm định t độc lập và phân tích phương sai một yếu tố. Tỷ lệ T2 RV/LV có tương quan vừa phải với các phân vị của khoảng cách danh nghĩa trong 6MWT (r = 0.66) trong khi phân suất tống máu, thể tích cuối tâm trương và cuối tâm thu không cho thấy sự tương quan (r = 0.09, 0.07 và -0.01, tương ứng). Thêm vào đó, có sự khác biệt đáng kể trong tỷ lệ T2 RV/LV giữa các bệnh nhân có và không có khó thở sau gắng sức đáng kể (p = 0.001). Phân tích hồi quy cho thấy tỷ lệ T2 RV/LV là một yếu tố dự đoán độc lập về khoảng cách đi bộ và sự hiện diện của khó thở sau gắng sức (p < 0.001). Tỷ lệ T2 RV/LV được đề xuất, thu được bằng hai phép đo đơn giản trên bản đồ T2 bốn buồng thường quy, đã vượt trội hơn so với các thông số chức năng tim đã được thiết lập trong việc dự đoán khả năng vận động và sự hiện diện của khó thở sau gắng sức ở bệnh nhân suy tim mãn tính.

Từ khóa

#MRI tim #suy tim mãn tính #thời gian thư giãn T2 #khả năng vận động #khó thở sau gắng sức #phân tích hồi quy

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