Affiliation:
1. Department of Radiology, West China Hospital Sichuan University Chengdu Sichuan China
2. Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education West China Second University Hospital, Sichuan University Chengdu Sichuan China
Abstract
BackgroundPatients 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.PurposeTo 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 TypeRetrospective.Population137 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/Sequence3.0T/Balanced steady‐state free precession sequence, recovery prepared echo‐planar imaging sequence, and phase‐sensitive inversion recovery sequence.AssessmentThe 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 TestsChi‐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.ResultsThe 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 ConclusionPTTc and PBVi are associated with diastolic dysfunction and deteriorated LV deformation, and PTTc independently predicts MACE in patients with RCM.Level of Evidence3Technical EfficacyStage 2
Funder
National Natural Science Foundation of China