| Background and Objective:To investigate the characteristics of cardiac function and the degree of myocardial damage in patients with pulmonary hypertension(PH)with or without ventricular septum(IVS)changes in shape through cardiac magnetic resonance(CMR).Methods and Materials:Thirty-six PH patients who were confirmed by right heart catheterization(RHC)at Tianjin Medical University General Hospital from October 2014 to February 2017 were enrolled.According to the interventricular septum morphology,the patients were divided into two groups: the IVS non-deformation group(10 patients)and the IVS deformation group(26 patients).CMR images of 22 healthy volunteers were compared and analyzed.Short axis images of ventricle were acquired with FIESTA.Ventricular morphology and functional parameters were measured and corrected for body surface area(BSA),including RV and LV end-diastolic volume index(EDVI),end-systolic volume index(ESVI),stroke volume index(SVI),cardiac index(CI),ejection fraction(EF),myocardial mass index(MMI).The characteristics of myocardial delayed contrast enhancement(DCE)distribution were observed and its mass was calculated.Delayed contrast enhancement mass index(DCEMMI)was corrected by BSA.To compare the myocardial quality of DCEMMI in IVS patients with deformation and non-deformation patients with PH.Statistical methods of ventricular function parameters using three independent samples ANOVA test,after multiple comparisons using LSD test.Myocardial DCEMMI in PH patients was tested using an independent sample t-test.Results:The overall ANOVA analysis showed significant differences in RVEDVI,RVESVI,RVSVI,RVCI,RVEF,RVMMI,LVEDVI,LVESVI,LVSVI and LVCI among the three groups for ventricular function parameters.Post-hoc LSD test showed that compared with control group,RVSVI(P=0.017),RVEF(P=0.000),LVEDVI(P =0.048)and LVSVI(P=0.015)were reduced in the IVS non-deformation group.Compared with the IVS non-deformation group,RVEDVI(P=0.000),RVESVI(P=0.000),RVCI(P=0.002)and RVMMI(P=0.017)were increased in the IVS deformation group;while RVEF(P=0.001),LVEDVI(P=0.003),LVSVI(P=0.000)and LVCI(P=0.029)were reduced.Compared with the control group,RVEDVI(P=0.000),RVESVI(P=0.000),RVCI(P=0.004),RVMMI(P=0.003)were increased in the IVS deformation group;while RVEF(P=0.000),LVEDVI(P=0.000),LVESVI(P=0.000),LVSVI(P=0.000)and LVCI(P=0.000)were lower than the control group.For DCEMMI parameters,t-test showed that the former DCEMMI(P=0.002)was higher than the latter between the IVS deformation group and the IVS non-deformation group.Conclusion:Different IVS shape in PH patients have different characteristics of ventricular function and myocardial damage.The deformation of IVS can reflect the changes of ventricular function and myocardial damage in PH patients. |
