Myocardial hypertrophy: the differentiation of uremic, hypertensive, and hypertrophic cardiomyopathies by cardiac MRI.

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Insights into Imaging Pub Date : 2024-08-01 DOI:10.1186/s13244-024-01770-0

Zhaoxin Tian, Shiqi Jin, Huaibi Huo, Yue Zheng, Yue Li, Hui Liu, Zhaodi Geng, Shutong Liu, Shinuo Li, Zequn Liu, Xinru Wang, Ting Liu

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Abstract

Objectives: To apply cardiac magnetic resonance imaging (CMR) for detailed myocardial characterization in uremic cardiomyopathy (UC), hypertensive cardiomyopathy (HTN), and hypertrophic cardiomyopathy (HCM) aiming to enrich the understanding of UC's etiology and further support the development of therapeutic strategies.

Methods: A total of 152 patients (age: 49.2 ± 9.9 years; 65.8% male) underwent routine CMR from June 2016 to March 2023. Retrospectively, 53 patients with UC, 39 patients with HTN, 30 patients with HCM, and 30 healthy controls were included. Functional analysis, feature tracking of the left ventricle and left atrium, and myocardial T1, T2, and T2* mapping were performed. Statistical analysis included Pearson correlation and ROC analysis to define correlations and discriminators between groups.

Results: UC patients demonstrated significantly higher native T1 (p < 0.001 for all) and T2 (p < 0.002 for all) values compared with the other three groups. UC patients revealed higher left atrial reservoir strain rate (p < 0.001 for all) and left atrial conduit strain rate (p < 0.001 for all) absolute values as compared with HTN and HCM patients. A significant correlation between T1 and T2 values in UC patients (r = 0.511, p < 0.001) was found. The combination of T1 values and strain parameters was the best discriminator between UC and HTN patients (AUC = 0.872, 95% CI: 0.801-0.943) and between UC and HCM patients (AUC = 0.840, 95% CI: 0.746-0.934).

Conclusion: UC reveals distinguishing tissue characteristics as evidenced by T1 and T2 mapping, as well as distinguishing functional strain parameters as compared with other hypertrophic phenotypes such as HTN and HCM.

Critical relevance statement: The use of CMR imaging in UC patients offers incremental information to elucidate its complex etiology, contributing to ongoing discourse on effective treatment pathways.

Key points: This study investigated uremic, hypertensive, and hypertrophic cardiomyopathies using cardiac MRI. UC patients have higher T1 and T2 values and better preserved cardiac function. Combined strain and T1 values distinguish UC from other cardiomyopathies.

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心肌肥厚：通过心脏磁共振成像区分尿毒症、高血压和肥厚性心肌病。

研究目的应用心脏磁共振成像（CMR）对尿毒症心肌病（UC）、高血压心肌病（HTN）和肥厚型心肌病（HCM）的心肌特征进行详细描述，旨在丰富对UC病因的认识，进一步支持治疗策略的开发：2016年6月至2023年3月期间，共有152名患者（年龄：49.2 ± 9.9岁；65.8%为男性）接受了常规CMR检查。回顾性纳入 53 名 UC 患者、39 名 HTN 患者、30 名 HCM 患者和 30 名健康对照组。进行了功能分析、左心室和左心房特征追踪以及心肌T1、T2和T2*映射。统计分析包括皮尔逊相关性和 ROC 分析，以确定组间的相关性和鉴别因素：结果：UC 患者的原生 T1 明显较高（p 结论：UC 患者的原生 T1 明显较高（p）：与其他肥厚表型（如 HTN 和 HCM）相比，UC 的 T1 和 T2 映射显示出不同的组织特征，以及不同的功能应变参数：在尿毒症患者中使用 CMR 成像可为阐明其复杂病因提供更多信息，有助于持续讨论有效的治疗途径：本研究使用心脏磁共振成像技术研究了尿毒症、高血压和肥厚性心肌病。尿毒症患者的 T1 和 T2 值较高，心功能保存较好。综合应变和 T1 值可将尿毒症与其他心肌病区分开来。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.