| Part One Evaluation of left ventricular diastolic function in patients MRIObjective:To evaluate left ventricular diastolic function in patients with heart failure with preserved ejection fraction by cardiac MRI.Methods:From october 2018 to october 2019,30 patients with diastolic dysfunction?E/e'?15?in the Second Hospital of Hebei Medical University and26 healthy volunteers as a control group were included in our research.All participants received CMRI examination.The time-volume curve was obtained,and compared whether the parameters are different between the two groups.Results:The HFpEF group showed significantly lower than the control group in PFR1?FV1/FV?FV1?P<0.001?P<0.001?P<0.001?P<0.05?.PFR1:?0.19±0.06?m L?ms-1 vs?0.31±0.09?m L?ms-1?PFR1/PFR2:?0.72±0.20 vs2.38±0.93??FV1/FV:?0.55±0.14vs0.77±0.07??FV1:?27.95±10.62?m L vs?34.36±8.67?m L.According to the area under the ROC curve,the PFR2 and FV2showed good classification ability for diastolic function;when the PFR2cut-off point was 0.20 m L?ms-1 and the FV2 was 13.25 ml,its sensitivity was86.7%?93.3%,respectively;specificity was 76.9%?73.1%,respectively;there was no significant difference in the diagnosis of left ventricular diastolic dysfunction between PFR2 and FV2?P>0.05?.Conclusions:The PFR index of MRI was able to accurately evaluate the LV diastolic function parameters in patients with HFpEF,and when the PFR2cut-off point was 0.20 m L?ms-1 and the FV2 was 13.25 ml,its sensitivity was86.7%?93.3%,respectively;specificity was 76.9%?73.1%,respectively.MRI provides a reliable imaging basis for the diagnosis and evaluation of left ventricular function in patients with HFpEF.Part Two Evaluation of left ventricular function in hypertensive patients with cardiac MRI strainObjective:The evaluation of myocardial strain technique on left ventricular function status in hypertensive patients;explore the effect of blood pressure and other factors on left ventricular strain.Methods: From June 2018 to October 2019,110 people with asymptomatic hypertension from the Second Hospital of Hebei Medical University and 32 healthy volunteers as a control group were included in our research.According to blood pressure,they were divided into normal group,high blood pressure group I?II?III.All participants received CMR examination.the images were analyzed and processed using CVI42 postprocessing software to compare the left ventricular myocardial strain differences between groups,and multivariate linear regression analysis was used to analyze the relevant influencing factors of strain.Results: The systolic blood pressure and sex have effect on GLS,GCS and GRS?P<0.001?,with the increase of blood pressure the strain decreased;The strain of females were higher than males.Age has an eff ect on GRS?P<0.01?,and the strain increases with age;Patients showed s ignificant lower GLS,GCS than the control group?P<0.001?,GLS:?-13.57%±2.40%?-12.52%±1.87%?-11.52%±3.05%?versus?-19.83%± 2.01%?;GC S:?-16.37%±1.93%?-16.28%±2.21%?-15.14%± 3.74%?versus?-20.71%±2.09%?.But there was no significant difference in GRS between normal group and hypertension group I?II?P>0.05?,?51.01% ±9.56%?versus?49.98%±10.20%?46.39%±7.90%?.But the difference between hypertension group III and normal group was statistically significant?P<0.01?,?42.82%± 13.60%?versus?51.01%±9.56%?.Conclusions:The strain was mainly affected by systolic blood pressure?sex and age;the left ventricular longitudinal strain and circumferential strain in hypertension were significantly lower than those in normal,indicating that the systolic function may have been impaired;the radial strain in mild and moderate hypertension was not significantly different from that in normal.However,the peak diastolic strain rate in the three directions was significantly lower than that in normal,suggesting that the diastolic function may have been impaired.When the LVEF of hypertension patients is normal and there are no obvious clinical symptoms,the strain and diastolic strain rate index can detect the impairment of systolic and diastolic function earlier and more sensitively,and can reflect the myocardial pathological changes very early,which provides important guiding value for clinical early diagnosis,disease prediction and prognosis of patients. |
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