ABSTRACT
Objective:To evaluate the value of cardiac MR feature tracking (CMR-FT) on the early assessment of left ventricular subclinical myocardial dysfunction in patients of hypertensive heart disease (HHD).Methods:From October 2018 to November 2019, 16 HHD patients with left ventricular hypertrophy (HHD-LVH), 24 HHD patients without left ventricular hypertrophy (HHD-nonLVH) and 24 age-and gender-matched normotensive controls who underwent 3.0 T CMR examination were retrospectively enrolled. Imaging protocol included cine sequence and late gadolinium enhancement. Left ventricular function variables were measured using Argus software, mainly including left ventricular end-diastolic volume index (LVEDVI), left ventricular mass index (LVMI), left ventricular maximal wall thickness (LVMWT), the ratio of left ventricular mass to left ventricular end-diastolic volume (M/V). CMR-FT was performed using commercial software CVI 42, with parameters including global radial, circumferential, longitudinal strains (GRS, GCS, GLS), peak systolic radial, circumferential, longitudinal strain rate (SRSR peak, SCSR peak, SLSR peak) and peak diastolic radial, circumferential, longitudinal strain rate (DRSR peak, DCSR peak, DLSR peak) derived. One-way analysis of variance with scheffe correction or Kruskal-Wallis test was performed for multiple comparisons. Pearson or Spearman analysis was used for linear or monotonic nonlinear correlations. Results:HHD-LVH group had higher LVEDVI, LVMI, LVMWT and M/V than HHD-nonLVH group and control group ( P<0.05). Compared with control group, GRS, GCS and GLS were statistically impaired in HHD-LVH group, and DRSR peak, DCSR peak and DLSR peak were statistically reduced in HHD-LVH group and HHD-nonLVH group(all P<0.05). Correlation analysis showed that LVMI correlated linearly with GRS ( r=-0.384, P=0.002), GCS ( r=0.392, P=0.001) and GLS ( r=0.491, P<0.0001),LVMWT correlated nonlinearly with GRS ( r=-0.362, P=0.003), GCS ( r=0.384, P=0.002) and GLS ( r=0.422, P=0.001), LVEDVI correlated nonlinearly with GRS ( r=-0.295, P=0.018) and GCS ( r=0.264, P=0.035). Conclusion:CMR-FT derived left ventricular strain parameters could be served as early indicators for the assessment of subclinical myocardial dysfunction in HHD patients, which have great potential in guiding appropriate intervention therapy and improving cardiac remodeling.
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Objective:To investigate the value of chest CT quantitative index in clinical classification and lung injury severity evaluation of COVID-19.Methods:The current study retrospectively analyzed the clinical and CT data of 438 patients with COVID-19 between January 2020 and March 2020 in Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology. The clinical types included common type ( n=146), severe type ( n=247) and critical type ( n=45). The chest CT indexes of all patients were quantitatively analyzed by artificial intelligence (AI) deep learning, including whole lung volume, CT lung opacification, ground glass opacification volume (GGO volume; CT value<-300 HU), solid opacification volume (SO volume; CT value ≥-300 HU) and the ratio of volume to the whole lung volume, the ratio of SO volume to GGO volume (SO volume/GGO volume). Kruskal-Wallis test was used to conduct statistical analysis of the differences in quantitative parameters among clinical types, and multiple ordered logistic regression was used to analyze the correlation between quantitative parameters and clinical types. Results:Among the 438 patients diagnosed with COVID-19, severe and critical patients were older ( P<0.05), and most of the critical patients were male ( P<0.05). The main clinical manifestations of all clinical types were fever, followed by cough, fatigue, chest tightness, dyspnea, gastrointestinal symptoms and so on. GGO volume was the main CT manifestation of all the three clinical subtypes. The whole-lung opacification volume, GGO volume, SO volume and their proportions in whole-lung volume significantly increased from common, severe to critical types (all P<0.05). SO volume/GGO volume increased with the severity of clinical type [common type 0.12 (0.03, 0.34), severe type 0.29 (0.11, 0.59), critical type 0.61 (0.39, 0.97)]. Multiple ordered logistic regression analysis showed that whole-lung opacification volume (OR=1.009), SO volume/GGO volume (OR=1.866), GGO volume (OR=1.008) and SO volume (OR=1.016) had a significant positive effect on the severity of clinical typing ( P<0.01). Conclusion:Quantitative indicators of chest CT based on deep learning algorithm (SO volume, GGO volume, SO volume/GGO volume) are closely related to the clinical severity of COVID-19.
ABSTRACT
Objective To study the diagnostic value of non-contrast T1mapping in left ventricular hypertrophy(LVH).Methods Forty LVH patients(LVH group)including 11 cardiac amyloidosis(CA),19 hypertrophic cardiomyopathy (HCM) and 10 hypertensive heart disease (HHD) patients, and 14 healthy volunteers (control group) were enrolled in this retrospective study between November 2015 and October 2016.All subjects underwent cardiac magnetic resonance(CMR)on a 3 T scanner.The CMR scan protocol included cine sequences, first-pass perfusion, late Gadolinium enhancement (LGE) and non-contrast T1 mapping(MOLLI)prototype sequences.The cardiac morphology was assessed by cine,first-pass perfusion as well as LGE.Left-ventricular end-diastolic wall thickness(EDTH)was assessed for 16 segments,native T1 values were measured in hypertrophic segments. The differences in EDTH and native T1values between LVH group and control group were evaluated using t test. The ANOVA and LSD were used in the comparison of differences among four sub-groups.Sensitivity,specificity,cut-off values and area under the curve (AUC) were derived using receiver-operating characteristics curve (ROC) analysis. Results The EDTH and native T1values in LVH group were significantly higher than those of control group[(16.5±5.2)mm vs.(6.3±1.8)mm,(1 388.6±119.8)ms vs.(1 248.4±58.1)ms,t=28.8 16.4,both P<0.01].Moreover,CA showed significantly higher T1value [(1 495.5 ± 100.9)ms] than that of HCM [(1 342.0 ± 69.2)ms] and HDD [(1 290.7±45.5)ms](F=300.5,P<0.01),and T1values in HCM were also higher than HDD(P<0.01).HCM showed significantly higher EDTH than that of CA and HDD (P<0.01), and EDTH in CA was also higher than HDD (P<0.01). The native T1showed good diagnostic performance between CA and HCM with AUC 0.914,sensitivity 90.1%%,and specificity 84.3%,and cutoff value 1 382.8 ms,between CA and HHD with AUC 0.989,sensitivity 97.0%,specificity 93.5% and cutoff value 1 359.5 ms.Conclusion The elevated native T1values were useful for quantitatively differential diagnosis of LVH.