心肌应变技术评价右室功能的研究进展
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摘要
右心功能在心血管疾病的诊断以及预后评估中扮演着重要角色。但由于右室结构及运动的复杂性,右心功能的准确高效评估一直面临挑战。近些年来发展的心肌应变技术能够定量评估右室心肌的局部及整体收缩功能,为右室疾病提供新的诊断及预后信息。本文主要概述右室的解剖及生理学,心肌应变技术的特点及其在右室功能评价中的应用。
Right ventricular function plays an important role in the diagnosis and prognosis of many cardiovascular diseases.However,due to the complexity of right ventricular morphology and movement,accurate and efficient assessment of right ventricular function has always been challenging.In recent years,newly developed myocardial strain techniques can quantitatively assess the local and global systolic function of right ventricular myocardium,providing rich diagnostic and prognostic information for right ventricular diseases.This article mainly summarizes the anatomy and physiological of the right ventricle,the characteristics of myocardial strain technique and its application in the evaluation of right ventricular function.
Right ventricular function plays an important role in the diagnosis and prognosis of many cardiovascular diseases.However,due to the complexity of right ventricular morphology and movement,accurate and efficient assessment of right ventricular function has always been challenging.In recent years,newly developed myocardial strain techniques can quantitatively assess the local and global systolic function of right ventricular myocardium,providing rich diagnostic and prognostic information for right ventricular diseases.This article mainly summarizes the anatomy and physiological of the right ventricle,the characteristics of myocardial strain technique and its application in the evaluation of right ventricular function.
引文
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[2] Lorenz CH,Walker ES,Morgan VL,et al.Normal human right and left ventricular mass,systolic function,and gender differences by cine magnetic resonance imaging[J].J Cardiovas Magn Reson,1999,1(1):7-21.
[3] Ho SY,Nihoyannopoulos P.Anatomy,echocardiography,and normal right ventricular dimensions[J].Heart,2006,92(suppl 1):i2-i13.
[4] Sheehan F,Redington A.The right ventricle:anatomy,physiology and clinical imaging[J].Heart,2008,94(11):1510-1515.
[5] 3Rd GJ,Tanaka H.Echocardiographic assessment of myocardial strain[J].JACC,2011,58(14):1401-1413.
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[7] 向丹,薛鸿.超声影像应变成像技术的临床应用研究进展[J].西部医学,2017,29(1):145-148.
[8] Petitjean C,Rougon N,Cluzel P.Assessment of myocardial function:a review of quantification methods and results using tagged MRI[J].J Cardiovasc Mag Reson,2005,7(2):501-516.
[9] Zerhouni EA,Parish DM,Rogers WJ,et al.Human heart:tagging with MR imaging--a method for noninvasive assessment of myocardial motion[J].Radiology,1988,169(1):59-63.
[10] 史河水,曹玉坤.磁共振评价左室心肌应变技术及其临床应用的研究进展[J].临床心血管病杂志,2017,33(12):1135-1139.
[11] 闫钟钰,李坤成.MRI在评价局部心功能中的应用及其进展[J].临床放射学杂志,2005,24(10):922-925.
[12] Osman NF,Sampath S,Atalar E,et al.Imaging longitudinal cardiac strain on short-axis images using strain-encoded MRI[J].Magn Reson Med,2010,46(2):324-334.
[13] Scatteia A,Baritussio A,Bucciarelliducci C.Strain imaging using cardiac magnetic resonance[J].Heart Fail Rev,2017,22(4):465-476.
[14] Al-Agamy AO,Osman NF,Fahmy AS.Myocardium segmentation in strain-encoded (SENC) magnetic resonance images using graph-cuts[J].Iet Image Processing,2013,7(5):415-422.
[15] Wang H,Amini AA.Cardiac motion and deformation recovery from MRI:a review[J].IEEE Trans Med Imaging,2012,31(2):487-503.
[16] Auger DA,Zhong X,Epstein FH,et al.Mapping right ventricular myocardial mechanics using 3D cine DENSE cardiovascular magnetic resonance[J].J Cardiovasc Magn Reson,2012,14(1):1-9.
[17] Schuster A,Morton G,Hussain ST,et al.The intra-observer reproducibility of cardiovascular magnetic resonance myocardial feature tracking strain assessment is independent of field strength[J].Eur J Radiol,2013,82(2):296-301.
[18] Wu VCC,Takeuchi M.Echocardiographic assessment of right ventricular systolic function[J].Cardiovasc Diag Therapy,2018,8(1):70-70.
[19] Fine NM,Chen L,Bastiansen PM,et al.Reference values for right ventricular strain in patients without cardiopulmonary disease:a prospective evaluation and meta‐analysis[J].Echocardiography,2015,32(5):787-796.
[20] Lang RM,Badano LP,Mor-Avi V,et al.Recommendations for cardiac chamber quantification by echocardiography in adults:an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J].Eur Heart J Cardiovasc Imaging,2015,17(4):412.
[21] Vo HQ,Marwick TH,Negishi K.MRI-derived myocardial strain measures in normal subjects[J].JACC Cardiovas Imaging,2018,11(2 pt 1):196-205.
[22] Liu B,Dardeer AM,Moody WE,et al.Normal values for myocardial deformation within the right heart measured by feature-tracking cardiovascular magnetic resonance imaging[J].Int J Cardiol,2018,252:220-223.
[23] Truong VT,Safdar KS,Kalra DK,et al.Cardiac magnetic resonance tissue tracking in right ventricle:feasibility and normal values[J].Magn Reson Imaging,2017,38:189-195.
[24] 龚捷,徐晓飞.肺动脉高压早期诊断的研究进展[J].临床心血管病杂志,2018,34(10):1028-1031.
[25] Siqueira ME,Pozo E,Fernandes VR,et al.Characterization and clinical significance of right ventricular mechanics in pulmonary hypertension evaluated with cardiovascular magnetic resonance feature tracking[J].J Cardiovas Magn Reson,2016,18(1):39.
[26] Shehata ML,Lossnitzer D,Skrok J,et al.Myocardial delayed enhancement in pulmonary hypertension:pulmonary hemodynamics,right ventricular function,and remodeling[J].AJR Am J Roentgenol,2011,196(1):87-94.
[27] Maschke SK,Schoenfeld CO,Kaireit TF,et al.MRI-derived regional biventricular function in patients with chronic thromboembolic pulmonary hypertension before and after pulmonary endarterectomy[J].Acad Radiol,2018,25(12):1540-1547.
[28] Wichter PDT,Paul TM,Eckardt L,et al.Arrhythmogenic right ventricular cardiomyopathy[J].Herz Kardiovaskul?re Erkrankungen,2005,30(2):91-101.
[29] Sarvari SI,Haugaa KH,Anfinsen OG,et al.Right ventricular mechanical dispersion is related to malignant arrhythmias:a study of patients with arrhythmogenic right ventricular cardiomyopathy and subclinical right ventricular dysfunction[J].Eur Heart J,2011,32(9):1089-1096.
[30] Vigneault DM,Te Riele AS,James CA,et al.Right ventricular strain by MR quantitatively identifies regional dysfunction in patients with arrhythmogenic right ventricular cardiomyopathy[J].J Magn Reson Imaging,2016,43(5):1132-1139.
[31] Prati G,Vitrella G,Allocca G,et al.Right ventricular strain and dyssynchrony assessment in arrhythmogenic right ventricular cardiomyopathy:cardiac magnetic resonance feature-tracking study[J].Circ Cardiovas Imaging,2016,25(11):S248-S248.
[32] Orwat S,Diller GP,Kempny A,et al.Myocardial deformation parameters predict outcome in patients with repaired tetralogy of Fallot[J].Heart,2016,102(3):209-215.
[33] Yim D,Mertens L,Morgan C T,et al.Impact of surgical pulmonary valve replacement on ventricular mechanics in children with repaired tetralogy of Fallot[J].Int J Cardiovasc Imaging,2017,33(5):1-10.
[34] Kalaitzidis P,Orwat S,Kempny A,et al.Biventricular dyssynchrony on cardiac magnetic resonance imaging and its correlation with myocardial deformation,ventricular function and objective exercise capacity in patients with repaired tetralogy of Fallot[J].Int J Cardiol,2018,264:53-57.
[35] Tutarel O,Orwat S,Radke R M,et al.Assessment of myocardial function using MRI-based feature tracking in adults after atrial repair of transposition of the great arteries:reference values and clinical utility[J].Int J Cardiol,2016,220:246-250.
[36] Menting ME,Ae VDB,Mcghie JS,et al.Ventricular myocardial deformation in adults after early surgical repair of atrial septal defect[J].Eur Heart J Cardiovas Imaging,2015,16(5):549-557.
[37] 朱思来,宋越,谢明星,等.二维超声斑点追踪成像评价慢性阻塞性肺疾病患者早期右心室收缩功能改变[J].临床心血管病杂志,2018,34(11):1133-1136.
[38] Nakano S,Takahashi M,Kimura F,et al.Cardiac magnetic resonance imaging-based myocardial strain study for evaluation of cardiotoxicity in breast cancer patients treated with trastuzumab:a pilot study to evaluate the feasibility of the method[J].Cardiol J,2016,23(3):270-280.
[39] Huttin O,Lemarié J,Di Meglio M,et al.Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography[J].IntJ Cardiovas Imaging,2015,31(3):537-545.
[40] Mazurkiewicz ?,Petryka J,Spiewak M,et al.Biventricular mechanics in prediction of severe myocardial fibrosis in patients with dilated cardiomyopathy:CMR study[J].Eur J Radiol,2017,91:71-81.
[41] Vitarelli A,Lai S,Petrucci M T,et al.Biventricular assessment of light-chain amyloidosis using 3D speckle tracking echocardiography:differentiation from other forms of myocardial hypertrophy[J].Int JCardiol,2018,271:371-377.
[2] Lorenz CH,Walker ES,Morgan VL,et al.Normal human right and left ventricular mass,systolic function,and gender differences by cine magnetic resonance imaging[J].J Cardiovas Magn Reson,1999,1(1):7-21.
[3] Ho SY,Nihoyannopoulos P.Anatomy,echocardiography,and normal right ventricular dimensions[J].Heart,2006,92(suppl 1):i2-i13.
[4] Sheehan F,Redington A.The right ventricle:anatomy,physiology and clinical imaging[J].Heart,2008,94(11):1510-1515.
[5] 3Rd GJ,Tanaka H.Echocardiographic assessment of myocardial strain[J].JACC,2011,58(14):1401-1413.
[6] Teske AJ,De Boeck BWL,Olimulder M,et al.Echocardiographic assessment of regional right ventricular function:a head-to-head comparison between 2-dimensional and tissue Doppler-derived strain analysis[J].J Am Soc Echocardiogr,2008,21(3):275-283.
[7] 向丹,薛鸿.超声影像应变成像技术的临床应用研究进展[J].西部医学,2017,29(1):145-148.
[8] Petitjean C,Rougon N,Cluzel P.Assessment of myocardial function:a review of quantification methods and results using tagged MRI[J].J Cardiovasc Mag Reson,2005,7(2):501-516.
[9] Zerhouni EA,Parish DM,Rogers WJ,et al.Human heart:tagging with MR imaging--a method for noninvasive assessment of myocardial motion[J].Radiology,1988,169(1):59-63.
[10] 史河水,曹玉坤.磁共振评价左室心肌应变技术及其临床应用的研究进展[J].临床心血管病杂志,2017,33(12):1135-1139.
[11] 闫钟钰,李坤成.MRI在评价局部心功能中的应用及其进展[J].临床放射学杂志,2005,24(10):922-925.
[12] Osman NF,Sampath S,Atalar E,et al.Imaging longitudinal cardiac strain on short-axis images using strain-encoded MRI[J].Magn Reson Med,2010,46(2):324-334.
[13] Scatteia A,Baritussio A,Bucciarelliducci C.Strain imaging using cardiac magnetic resonance[J].Heart Fail Rev,2017,22(4):465-476.
[14] Al-Agamy AO,Osman NF,Fahmy AS.Myocardium segmentation in strain-encoded (SENC) magnetic resonance images using graph-cuts[J].Iet Image Processing,2013,7(5):415-422.
[15] Wang H,Amini AA.Cardiac motion and deformation recovery from MRI:a review[J].IEEE Trans Med Imaging,2012,31(2):487-503.
[16] Auger DA,Zhong X,Epstein FH,et al.Mapping right ventricular myocardial mechanics using 3D cine DENSE cardiovascular magnetic resonance[J].J Cardiovasc Magn Reson,2012,14(1):1-9.
[17] Schuster A,Morton G,Hussain ST,et al.The intra-observer reproducibility of cardiovascular magnetic resonance myocardial feature tracking strain assessment is independent of field strength[J].Eur J Radiol,2013,82(2):296-301.
[18] Wu VCC,Takeuchi M.Echocardiographic assessment of right ventricular systolic function[J].Cardiovasc Diag Therapy,2018,8(1):70-70.
[19] Fine NM,Chen L,Bastiansen PM,et al.Reference values for right ventricular strain in patients without cardiopulmonary disease:a prospective evaluation and meta‐analysis[J].Echocardiography,2015,32(5):787-796.
[20] Lang RM,Badano LP,Mor-Avi V,et al.Recommendations for cardiac chamber quantification by echocardiography in adults:an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J].Eur Heart J Cardiovasc Imaging,2015,17(4):412.
[21] Vo HQ,Marwick TH,Negishi K.MRI-derived myocardial strain measures in normal subjects[J].JACC Cardiovas Imaging,2018,11(2 pt 1):196-205.
[22] Liu B,Dardeer AM,Moody WE,et al.Normal values for myocardial deformation within the right heart measured by feature-tracking cardiovascular magnetic resonance imaging[J].Int J Cardiol,2018,252:220-223.
[23] Truong VT,Safdar KS,Kalra DK,et al.Cardiac magnetic resonance tissue tracking in right ventricle:feasibility and normal values[J].Magn Reson Imaging,2017,38:189-195.
[24] 龚捷,徐晓飞.肺动脉高压早期诊断的研究进展[J].临床心血管病杂志,2018,34(10):1028-1031.
[25] Siqueira ME,Pozo E,Fernandes VR,et al.Characterization and clinical significance of right ventricular mechanics in pulmonary hypertension evaluated with cardiovascular magnetic resonance feature tracking[J].J Cardiovas Magn Reson,2016,18(1):39.
[26] Shehata ML,Lossnitzer D,Skrok J,et al.Myocardial delayed enhancement in pulmonary hypertension:pulmonary hemodynamics,right ventricular function,and remodeling[J].AJR Am J Roentgenol,2011,196(1):87-94.
[27] Maschke SK,Schoenfeld CO,Kaireit TF,et al.MRI-derived regional biventricular function in patients with chronic thromboembolic pulmonary hypertension before and after pulmonary endarterectomy[J].Acad Radiol,2018,25(12):1540-1547.
[28] Wichter PDT,Paul TM,Eckardt L,et al.Arrhythmogenic right ventricular cardiomyopathy[J].Herz Kardiovaskul?re Erkrankungen,2005,30(2):91-101.
[29] Sarvari SI,Haugaa KH,Anfinsen OG,et al.Right ventricular mechanical dispersion is related to malignant arrhythmias:a study of patients with arrhythmogenic right ventricular cardiomyopathy and subclinical right ventricular dysfunction[J].Eur Heart J,2011,32(9):1089-1096.
[30] Vigneault DM,Te Riele AS,James CA,et al.Right ventricular strain by MR quantitatively identifies regional dysfunction in patients with arrhythmogenic right ventricular cardiomyopathy[J].J Magn Reson Imaging,2016,43(5):1132-1139.
[31] Prati G,Vitrella G,Allocca G,et al.Right ventricular strain and dyssynchrony assessment in arrhythmogenic right ventricular cardiomyopathy:cardiac magnetic resonance feature-tracking study[J].Circ Cardiovas Imaging,2016,25(11):S248-S248.
[32] Orwat S,Diller GP,Kempny A,et al.Myocardial deformation parameters predict outcome in patients with repaired tetralogy of Fallot[J].Heart,2016,102(3):209-215.
[33] Yim D,Mertens L,Morgan C T,et al.Impact of surgical pulmonary valve replacement on ventricular mechanics in children with repaired tetralogy of Fallot[J].Int J Cardiovasc Imaging,2017,33(5):1-10.
[34] Kalaitzidis P,Orwat S,Kempny A,et al.Biventricular dyssynchrony on cardiac magnetic resonance imaging and its correlation with myocardial deformation,ventricular function and objective exercise capacity in patients with repaired tetralogy of Fallot[J].Int J Cardiol,2018,264:53-57.
[35] Tutarel O,Orwat S,Radke R M,et al.Assessment of myocardial function using MRI-based feature tracking in adults after atrial repair of transposition of the great arteries:reference values and clinical utility[J].Int J Cardiol,2016,220:246-250.
[36] Menting ME,Ae VDB,Mcghie JS,et al.Ventricular myocardial deformation in adults after early surgical repair of atrial septal defect[J].Eur Heart J Cardiovas Imaging,2015,16(5):549-557.
[37] 朱思来,宋越,谢明星,等.二维超声斑点追踪成像评价慢性阻塞性肺疾病患者早期右心室收缩功能改变[J].临床心血管病杂志,2018,34(11):1133-1136.
[38] Nakano S,Takahashi M,Kimura F,et al.Cardiac magnetic resonance imaging-based myocardial strain study for evaluation of cardiotoxicity in breast cancer patients treated with trastuzumab:a pilot study to evaluate the feasibility of the method[J].Cardiol J,2016,23(3):270-280.
[39] Huttin O,Lemarié J,Di Meglio M,et al.Assessment of right ventricular functional recovery after acute myocardial infarction by 2D speckle-tracking echocardiography[J].IntJ Cardiovas Imaging,2015,31(3):537-545.
[40] Mazurkiewicz ?,Petryka J,Spiewak M,et al.Biventricular mechanics in prediction of severe myocardial fibrosis in patients with dilated cardiomyopathy:CMR study[J].Eur J Radiol,2017,91:71-81.
[41] Vitarelli A,Lai S,Petrucci M T,et al.Biventricular assessment of light-chain amyloidosis using 3D speckle tracking echocardiography:differentiation from other forms of myocardial hypertrophy[J].Int JCardiol,2018,271:371-377.