Association of Pulmonary Transit Time and Pulmonary Blood Volume From First-Pass Perfusion Cardiac MRI With Diastolic Dysfunction and Left Ventricle Deformation in Restrictive Cardiomyopathy

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-02-14 DOI:10.1002/jmri.29283

Yue Gao MD, Chen-Yan Min MS, Yi-Ning Jiang MS, Rui Shi MS, Ying-Kun Guo MD, Hua-Yan Xu MD, Zhi-Gang Yang MD, Yuan Li MD

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Abstract

Background

Patients with restrictive cardiomyopathy (RCM) have impaired diastolic filling and hemodynamic congestion. Pulmonary transit time (PTT) and pulmonary blood volume index (PBVi) reflect the hemodynamic status, but the relationship with left ventricle (LV) dysfunction remains unclear.

Purpose

To evaluate the PTT and PBVi in RCM patients, the association with diastolic dysfunction and LV deformation, and the effects on the occurrence of major adverse cardiac events (MACE) in RCM patients.

Study Type

Retrospective.

Population

137 RCM patients (88 men, age 58.80 ± 10.83 years) and 68 age- and sex-matched controls (46 men, age 57.00 ± 8.59 years).

Field Strength/Sequence

3.0T/Balanced steady-state free precession sequence, recovery prepared echo-planar imaging sequence, and phase-sensitive inversion recovery sequence.

Assessment

The LV function and peak strain (PS) parameters were measured. The PTT was calculated and corrected by heart rate (PTTc). The PBVi was calculated as the product of PTTc and RV stroke volume index.

Statistical Tests

Chi-squared test, student's t-test, Mann–Whitney U test, Pearson's or Spearman's correlation, multivariate linear regression, Kaplan–Meier survival analysis, and Cox regression models analysis. A P-value <0.05 was considered statistically significant.

Results

The PTTc showed a significant correlation with the E/A ratio (r = 0.282), and PBVi showed a significant correlation with the E/e′ ratio, E/A ratio, and diastolic dysfunction stage (r = 0.222, 0.320, and 0.270). PTTc showed an independent association with LVEF, LV circumferential PS, and LV longitudinal PS (β = 0.472, 0.299, and 0.328). In Kaplan–Meier analysis, higher PTTc and PBVi were significantly associated with MACE. In multivariable Cox regression analysis, PTTc was a significantly independent predictor of the MACE in combination with both cardiac MRI functional and tissue parameters (hazard ratio: 1.23/1.32, 95% confidence interval: 1.10–1.42/1.20–1.46).

Data Conclusion

PTTc and PBVi are associated with diastolic dysfunction and deteriorated LV deformation, and PTTc independently predicts MACE in patients with RCM.

Level of Evidence

Technical Efficacy

Stage 2

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一过性灌注心脏磁共振成像显示的肺通气时间和肺血量与限制性心肌病舒张功能障碍和左心室变形的关系

背景：限制性心肌病（RCM）患者舒张期充盈受损，血流动力学充血。目的：评估 RCM 患者的 PTT 和 PBVi、与舒张功能障碍和 LV 变形的关系，以及对 RCM 患者主要心脏不良事件（MACE）发生的影响：研究类型：回顾性研究：137 名 RCM 患者（88 名男性，年龄 58.80 ± 10.83 岁）和 68 名年龄和性别匹配的对照组（46 名男性，年龄 57.00 ± 8.59 岁）：3.0T/平衡稳态自由前序序列、恢复准备回声平面成像序列和相敏反转恢复序列：测量左心室功能和峰值应变（PS）参数。计算 PTT，并根据心率进行校正（PTTc）。PBVi计算为PTTc与RV搏出量指数的乘积：方差分析、学生 t 检验、Mann-Whitney U 检验、Pearson 或 Spearman 相关性、多变量线性回归、Kaplan-Meier 生存分析和 Cox 回归模型分析。A P值结果：PTTc 与 E/A 比值呈显著相关（r = 0.282），PBVi 与 E/e' 比值、E/A 比值和舒张功能障碍分期呈显著相关（r = 0.222、0.320 和 0.270）。PTTc 与 LVEF、左心室周向 PS 和左心室纵向 PS 呈独立相关性（β = 0.472、0.299 和 0.328）。在 Kaplan-Meier 分析中，较高的 PTTc 和 PBVi 与 MACE 显著相关。在多变量Cox回归分析中，PTTc与心脏磁共振成像功能和组织参数相结合，是MACE的重要独立预测因素（危险比：1.23/1.32，95%置信区间：1.10-1.42/1.20-1.46）：数据结论：PTTc和PBVi与舒张功能障碍和左心室变形恶化有关，PTTc可独立预测RCM患者的MACE：3 技术效率：第 2 阶段。

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