Differential value of cardiac magnetic resonance segpsychiatric Native T1 and tissue tracing in hypertrophic cardiomyopathy and hypertensive heart disease
WANG Junhe1, 2, FEI Jingle1, SU Yanping1, 2, CHEN Weiyue3, JI Jiansong1, 3, LU Chenying1, 3
1.Department of Radiology, the Fifth Affiliated Hospital of Wenzhou Medical University (Lishui Municipal Central Hospital), Lishui 323000, China; 2.The First School of Medicine, School of Information and Engineering,Wenzhou Medical University, Wenzhou 325035, China; 3.Key Laboratory of Imaging Diagnosis and Minimally Invasive Research, the Fifth Affiliated Hospital of Wenzhou Medical University (Lishui Municipal Central Hospital), Lishui 323000, China
Abstract：Objective: To investigate the differential diagnostic value of segmental Native T1 and tissue tracking in hypertrophic cardiomyopathy (HCM) and hypertensive heart disease cardiomyopathy (HHD). Methods: From October 2018 to July 2022, 80 patients with HCM and 25 patients with HHD from the Fifth Affiliated Hospital of Wenzhou Medical University were included. The films and T1 mapping images of all subjects were processed by CVI42 software to obtain the conventional left ventricular function parameters, left ventricular myocardial strain parameters, Native T1 values of the whole and all segments. The cardiac magnetic resonance parameters of HCM and HHD patients were compared between groups, Univariate and multivariate Logistic regression analysis was used to screen the predictors and modeling analysis was carried out. ROC curve and area under curve (AUC) were used to evaluate the identification efficacy of parameters. Results: Clinical data showed that HHD patients were more male (P=0.048) and more smokers (P=0.032) compared with HCM patients; Compared with HHD patients, patients with HCM had higher left ventricular ejection fraction (LVEF) and more pronounced thickening of left ventricular wall thickness (LVMWT) at end-diastole, higher positive rate of late gadolinium enhancement (LGE) (P<0.001), whereas the left ventricular end diastolic volume index (LVEDVI) and the left ventricular end systolic volume index (LVESVI) were lower in HHD patients (P<0.01); The global radial strain (GRS) and global circumferential strain (GCS) of left ventricle in HCM patients were higher than those in HHD patients (P<0.05). Univariate and multivariate logistic regression analysis showed that 3D GCS (OR=0.68, 95%CI=0.48-0.95, P=0.025) and segment 8 Native T1 (OR=1.04, 95%CI=1.00-1.07, P=0.029) were predictors for HHD in HCM. The results of ROC curve showed that the AUC value of 3D GCS, segmental 8 native T1 and combined model was 0.751, 0.779 and 0.925, respectively. The sensitivity was 86.67%, 71.62% and 84.06%, and the specificity was 63.16%, 82.61% and 88.89%, respectively, with the AUC of the joint parameter model being the highest (P<0.05). Conclusion: Segmental Native T1 and tissue tracing techniques are of important value in the differential diagnosis of HCM and HHD, in which segmental 8 Native T1 and 3D GCS are predictors for the differential diagnosis of HHD in HCM.The combined model is most valuable in differential diagnosis.
