| Part 1:MR first-pass myocardial perfusion in evaluation ofmyocardialischemia in hypertrophic cardiomyopathyObjective:To evaluate the myocardial ischemia in hypertrophic cardiomyopathy(HCM)patients with MR first-pass myocardial perfusion.Methods:Totally 20 patients with HCM(HCM group)and 10 healthy volunteers(control group)underwent cardiac MR,including left ventricle short axial cine,first-pass myocardial perfusion and delayed enhancement.Left ventricular end-diastolic wall thickness(EDTH)was measured.The blood pool-signal strength curves of the near,middle and far segments of left ventricle were drawed,and then time to peak(tpeak),maximal upslope of time-intensity curve(Slopemax),peak signal intensity(SIpeak)were measured.According to EDTH,different segments of HCM were divided into non-hypertrophic subgroup and hypertrophic subgroup,which could further divided into slight group(15-19 mm),moderate group(20-24 mm)and severe hypertrophic group(25-29 mm).One-way ANOVA analysis was used to analyze the difference of tpeak?Slopemax?SIpeak among all groups,as well as each two groups.Results:The differences oftpeak?Slopemax between control group and non-hypertrophic segments of HCM had no statistical significance(both P>0.05).The differences oftpeak,Slopemsx between non-hypertrophic segments and hypertrophic segments of HCM had statistical significance(both P<0.05).Slopemax of slight hypertrophic group was higher than that of moderate and severe hypertrophic group(P<0.05).tpeak of moderate hypertrophic group was higher than that of slight hypertrophic group(P<0.05).However,no differences oftpeak?Slope were found between moderate and severe hypertrophic group(both P>0.05).The differences of SIpeak between each two subgroups had no statistical significance(all P>0.05).Conclusion:MR first-pass myocardial perfusion can help to understand myocardial ischemia of different hypertrophic segments of HCM,which providing important information for risk stratification,therapy planning and prognosis evaluation of HCM patients.Part 2 The correlation study between myocardial fibrosis,NT-proBNP and hs-cTnT in HCMObjective:Using LGE of CMR to discuss the correlation between myocardial fibrosis,NT-proBNP and hs-cTnT in HCM.Methods:28 patients of HCM who were diagnosed with complete clinical data underwent CMR,including left ventricle short axial cine and delayed enhancement,and measured plasma NT-proBNP and hs-cTnT.According to myocardial fibrosis we measured,we divided 28 patients of HCM into 3 subgroups,including LGE negative group named group A,the quantities of LGE positive segments less than 6 named group B,the quantities of LGE positive segments equal or more than 6 named group C.Using one-way ANOVA analysis NT-proBNP and hs-cTnT of 3 subgroups of HCM.Using visual integral method to quantitatively analyze the degree of myocardial fibrosis.Using linear correlation to test the relationships between total LGE numbers,NT-proBNP and hs-cTnT in group B,C.Results:The differences of NT-proBNP?hs-cTnT of group A,B,C in HCM had statistically significant(both P<0.05).Comparing the concentration of NT-proBNP of 3 groups,we knew that group C>group B>group A.The total number of LGE integrals was positively correlated with NT-proBNP and hs-cTnT in group B,C.Conclusion:The myocardial fibrosis was positively correlated with NT-proBNP and hs-cTnT,the more serious the myocardial fibrosis was,the higher level the NT-proBNP and hs-cTnT was,which can prevent the occurrence of adverse events and improve the prognosis of patients. |
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