Evaluation Of Biventricular Function In Hypertensive Patients By CMR-FT Technique

Background and Purpose:Hypertension(HTN)is a common comprehensive disease caused by many reasons.It is one of the main causes of cardiovascular death in the world.It can cause damage to heart,brain,kidney and other organs.Hypertensive heart disease(HHD)is an important cause of death in patients with hypertension.Therefore,early diagnosis of HHD can reduce the risk of adverse cardiac events and improve the prognosis of patients.Cardiac magnetic resonance feature tracking(CMR-FT)has been used in the evaluation of a variety of heart diseases,which provides a new idea for the early detection of subclinical HHD.At present,most trials use CMR-FT technology only to evaluate the left ventricular function of patients with hypertension,and rarely use this new technology to evaluate the right ventricle of patients with hypertension.Therefore,the purpose of this study is to evaluate the biventricular strain value of patients with subclinical hypertensive heart disease by CMR-FT technology,so as to early diagnose HHD and observe whether hypertension will cause damage to right ventricular function.Material and methods:In this study,49 patients with hypertension and 46 healthy volunteers were enrolled.The clinical data of the patients are consulted by the researcher in the medical record room.All patients underwent 1.5T cardiac MRI scan,and all film images were imported into the tracking analysis software.The software automatically recognized end-diastolic and end-systolic images and semi-automatically outlined the inner and outer membrane of the heart.Any deviation was manually adjusted.Paint after the completion of the software automatically calculate the normal cardiac function parameters(including left entricular ejection fraction LVEF,left ventricular diastolic/contraction LVEDV/LVESV,left ventricular stroke volume at the end of the output LVSV,etc.)and left ventricular overall longitudinal strain values(LVGLS),whole circumferential strain values(LVGCS),the whole radial strain values(LVGLS),right ventricular longitudinal strain values(RVGLS)as a whole.According to the obtained left ventricular ejection fraction(LVEF),the hypertension group was divided into LVEF>50% group(28 patients)and LVEF<50% group(21 patients),and then SPSS software was used for statistical analysis of all data.Results:The left ventricular global longitudinal strain,circumferental strain,radial strain and right ventricular global longitudinal strain in hypertensive LVEF<50% group were lower than those in hypertensive LVEF>50% group and healthy control group(LVGLS:-4.34±1.82 vs-11.94±2.30 vs-13.86±2.01;LVGCS:-7.55±2.89 vs-21.91±3.89 vs-23.08±2.15;LVGRS:8.55±3.64 vs 36.05±11.72 vs 38.95±9.11;RVGLS:-6.02±3.40 vs-13.18±2.65 vs-13.75±2.77;P 均<0.05);the left ventricular global longitudinal strain of patients with hypertensive LVEF > 50% was lower than that of control group(P < 0.05),the left ventricular global circumferential strain,radial strain and right ventricular global longitudinal strain were slightly lower than those of control group,but there was no significant difference(P < 0.05)>The values of left ventricular GLS,GCS,GRS and right ventricular GLS were negatively correlated with BMI,left ventricular end diastolic volume and end systolic volume respectively(P < 0.01),and positively correlated with age,LVEF and lvsv(P < 0.01);the values of left ventricular GCS were positively correlated with lvco(P < 0.05),while the values of left ventricular GLS and left ventricular GRS were not correlated with lvco(P= 0.094,0.286,0.057)。Conclusion:The strain value of left ventricular myocardium has changed before the decrease of left ventricular ejection fraction,which indicates that there is myocardial damage before the decrease of left ventricular ejection fraction.At the same time,the right ventricular myocardium of patients with hypertension will also be damaged,and the damage of right ventricle occurs later than that of left ventricle.