1 research outputs found
Π’1-ΠΊΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π² ΠΎΡΠ΅Π½ΠΊΠ΅ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ Π΄ΠΈΡΡΡΠ·Π½ΠΎΠ³ΠΎ ΡΠΈΠ±ΡΠΎΠ·Π° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° ΠΏΡΠΈ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ
Background: The assessment of diffuse myocardial fibrosis is necessary to plan the management of patients with various cardiovascular disorders, including hypertensive heart disease. The development of imaging techniques has enabled a non-invasive detection of left ventricular myocardial fibrosis by magnetic resonance imaging (MRI) with T1 mapping.Aim: By cardiac MRI, to identify risk factors for diffuse left ventricular myocardial fibrosis in patients with hypertensive heart disease.Materials and methods: This was a cross-sectional observational study in 50 outpatients with hypertensive heart disease, aged 46 to 82 years (median, 68 [64; 72] years) and bodyweight of 52 to 120 kg (median, 91 [80; 98] kg). Standard cardiac MRI with delayed contrast enhancement was performed with Optima MR450w GEM 1.5T (General Electric, USA). For assessment of diffuse myocardial fibrosis MRI mapping by 2D MOLLI (3-3-5) technique was used. The results were analyzed with Cvi42 software (Circle Cardiovascular Imaging Inc., USA). The potential risk factors included patientsβ age, gender, bodyweight, and diastolic heart failure.Results: The mean time of T1 relaxation without contrast enhancement was 1122.64 Β±63.67 ms, indicating the presence of myocardial fibrosis in 100% of the patients. Female patients had more advanced diffuse myocardial abnormalities (p 0.001). In the elderly patients, there was a direct correlation between their age and degree of fibrosis (p = 0.006). There was an inverse correlation between higher bodyweight and increased extracellular volume. Heart rhythm disorders and diastolic heart failure had no impact on the changes in the mapping parameters of the left ventricular myocardium and MRI-assessed cardiac output values. No correlation between the myocardial fibrosis and dyslipidemia/hyperlipidemia was found. There was a direct correlation between the native T1 mapping values and extracellular volume fraction (p = 0.004) and an inverse correlation between low values of post-contrast T1 mapping and increased extracellular volume fraction (p = 0.05).Conclusion: Π’1 mapping in patients with essential arterial hypertension allows for detection of diffuse myocardial fibrosis of the left ventricle, which is recognised as a major indicator of myocardial remodeling. Female gender, older age, and bodyweight were the factors associated with more advanced myocardial fibrosis.ΠΠΊΡΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΡΠ΅Π½ΠΊΠ° Π΄ΠΈΡΡΡΠ·Π½ΠΎΠ³ΠΎ ΡΠΈΠ±ΡΠΎΠ·Π° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π»Π΅Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ° ΠΈΠΌΠ΅Π΅Ρ Π±ΠΎΠ»ΡΡΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ Π΄Π»Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΡ ΡΠ°ΠΊΡΠΈΠΊΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ°Π·Π»ΠΈΡΠ½ΡΠΌΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡΠΌΠΈ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎ-ΡΠΎΡΡΠ΄ΠΈΡΡΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ, Π² ΡΠΎΠΌ ΡΠΈΡΠ»Π΅ ΠΏΡΠΈ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ. Π‘ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ΠΌ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ Π²ΠΈΠ·ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΡΡΠ°Π»ΠΎ Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΡΠΌ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½ΠΎΠ΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ ΡΠΈΠ±ΡΠΎΠ·Π° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π»Π΅Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ° ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΌΠ°Π³Π½ΠΈΡΠ½ΠΎ-ΡΠ΅Π·ΠΎΠ½Π°Π½ΡΠ½ΠΎΠΉ ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΠΈ (ΠΠ Π’) Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΈΠΊΠΈ 11-ΠΊΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ.Π¦Π΅Π»Ρ - ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΡΠ°ΠΊΡΠΎΡΡ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ Π΄ΠΈΡΡΡΠ·Π½ΠΎΠ³ΠΎ ΡΠΈΠ±ΡΠΎΠ·Π° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π»Π΅Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ° ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΠ Π’ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π ΡΠ°ΠΌΠΊΠ°Ρ
ΠΏΠΎΠΏΠ΅ΡΠ΅ΡΠ½ΠΎΠ³ΠΎ Π½Π°Π±Π»ΡΠ΄Π°ΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π°ΠΌΠ±ΡΠ»Π°ΡΠΎΡΠ½ΠΎΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ 50 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ΅ ΠΎΡ 46 Π΄ΠΎ 82 Π»Π΅Ρ (ΠΌΠ΅Π΄ΠΈΠ°Π½Π° Π²ΠΎΠ·ΡΠ°ΡΡΠ° ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 68 [64; 72] Π»Π΅Ρ) ΠΈ ΠΌΠ°ΡΡΠΎΠΉ ΡΠ΅Π»Π° ΠΎΡ 52 Π΄ΠΎ 120 ΠΊΠ³ (ΠΌΠ΅Π΄ΠΈΠ°Π½Π° ΠΌΠ°ΡΡΡ ΡΠ΅Π»Π° - 91 [80; 98] ΠΊΠ³). ΠΠ Π’ ΡΠ΅ΡΠ΄ΡΠ° Π²ΡΠΏΠΎΠ»Π½ΡΠ»ΠΈ Π½Π° Π°ΠΏΠΏΠ°ΡΠ°ΡΠ΅ Optima MR450w GEM 1,5 Π’Π» (General Electric, Π‘Π¨Π) ΠΏΠΎ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠΉ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠ΅ Π΄ΠΎ ΠΈ ΠΏΠΎΡΠ»Π΅ ΠΎΡΡΡΠΎΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΠΎΠ³ΠΎ ΡΡΠΈΠ»Π΅Π½ΠΈΡ. ΠΡΠ΅Π½ΠΊΡ Π΄ΠΈΡΡΡΠ·Π½ΠΎΠ³ΠΎ ΡΠΈΠ±ΡΠΎΠ·Π° ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΠΏΡΠΈ ΠΏΠΎΠΌΠΎΡΠΈ ΠΏΠΎΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ 2D MOLLI. ΠΠ°Π½Π½ΡΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π»ΠΈ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΠ½ΠΎΠ³ΠΎ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠ΅Π½ΠΈΡ cvi42 (Circle Cardiovascular Imaging Inc., Π‘Π¨Π). Π‘ΡΠ΅Π΄ΠΈ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈ Π²ΠΎΠ·ΡΠ°ΡΡ, ΠΏΠΎΠ», ΠΌΠ°ΡΡΡ ΡΠ΅Π»Π°, Π½Π°Π»ΠΈΡΠΈΠ΅ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ ΠΏΠΎ Π΄ΠΈΠ°ΡΡΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΎΠΌΡ ΡΠΈΠΏΡ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ΡΠ΅Π΄Π½Π΅Π΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅ Π±Π΅ΡΠΊΠΎΠ½-ΡΡΠ°ΡΡΠ½ΠΎΠ³ΠΎ Π²ΡΠ΅ΠΌΠ΅Π½ΠΈ Π’1-ΡΠ΅Π»Π°ΠΊΡΠ°ΡΠΈΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»ΠΎ 1122,64 Β±63,67 ΠΌΡ, ΡΡΠΎ ΡΠΊΠ°Π·ΡΠ²Π°Π΅Ρ Π½Π° ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ Π΄ΠΈΡΡΡΠ·Π½ΠΎΠ³ΠΎ ΡΠΈΠ±ΡΠΎΠ·Π° Ρ 100% ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ². ΠΠΎΠ»Π΅Π΅ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΠΎΠ΅ ΡΠ°Π·Π²ΠΈΡΠΈΠ΅ Π΄ΠΈΡΡΡΠ·Π½ΡΡ
ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΉ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° ΠΎΡΠΌΠ΅ΡΠ΅Π½ΠΎ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΆΠ΅Π½ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΠ»Π° (p 0,001). Π£ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² ΡΡΠ°ΡΡΠ΅ΠΉ Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ Π½Π°Π±Π»ΡΠ΄Π°Π΅ΡΡΡ ΠΏΡΡΠΌΠ°Ρ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΡ ΡΠΎΡΡΠ° ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΠΈΠ±ΡΠΎΠ·Π° ΠΎΡ Π²ΠΎΠ·ΡΠ°ΡΡΠ° (p = 0,006). ΠΡΡΠ²Π»Π΅Π½Π° ΠΎΠ±ΡΠ°ΡΠ½Π°Ρ ΡΠ²ΡΠ·Ρ ΠΌΠ΅ΠΆΠ΄Ρ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΌΠ°ΡΡΡ ΡΠ΅Π»Π° ΠΈ Π²Π½Π΅ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ΅ΠΌΠ°. ΠΠ°Π»ΠΈΡΠΈΠ΅ Π½Π°ΡΡΡΠ΅Π½ΠΈΠΉ ΡΠΈΡΠΌΠ° ΠΈ Π΄ΠΈΠ°ΡΡΠΎΠ»ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ΅ΡΠ΄Π΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ Π½ΠΈΠΊΠ°ΠΊ Π½Π΅ ΠΏΠΎΠ²Π»ΠΈΡΠ»ΠΎ Π½Π° ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠΎΠ² ΠΊΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π»Π΅Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ° ΠΈ Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ, Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡΡΠΈΡ
ΡΠ΅ΡΠ΄Π΅ΡΠ½ΡΠΉ Π²ΡΠ±ΡΠΎΡ ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΠ Π’. ΠΠ΅ Π±ΡΠ»ΠΎ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΎ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎΠ³ΠΎ Π²Π»ΠΈΡΠ½ΠΈΡ Π½Π°Π»ΠΈΡΠΈΡ Π΄ΠΈΡΠ»ΠΈΠΏΠΈΠ΄Π΅ΠΌΠΈΠΈ/Π³ΠΈΠΏΠ΅ΡΠ»ΠΈΠΏΠΈΠ΄Π΅ΠΌΠΈΠΈ Π½Π° ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π»Π΅Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ°. ΠΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π° ΠΏΡΡΠΌΠ°Ρ ΡΠ²ΡΠ·Ρ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ Π½Π°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π’1-ΠΊΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Ρ ΡΡΠ°ΠΊΡΠΈΠ΅ΠΉ Π²Π½Π΅ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ΅ΠΌΠ° (p = 0,004) ΠΈ ΠΎΠ±ΡΠ°ΡΠ½Π°Ρ ΡΠ²ΡΠ·Ρ ΡΠΌΠ΅Π½ΡΡΠ΅Π½ΠΈΡ Π·Π½Π°ΡΠ΅Π½ΠΈΠΉ ΠΏΠΎΡΡΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΠΎΠ³ΠΎ Π’1 -ΠΊΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ Ρ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΡΡΠ°ΠΊΡΠΈΠΈ Π²Π½Π΅ΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΠΎΠ±ΡΠ΅ΠΌΠ° (p = 0,05).ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π’1-ΠΊΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π³ΠΈΠΏΠ΅ΡΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΡΡ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π²ΡΡΠ²ΠΈΡΡ Π΄ΠΈΡΡΡΠ·Π½ΡΠΉ ΡΠΈΠ±ΡΠΎΠ· ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π° Π»Π΅Π²ΠΎΠ³ΠΎ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠΊΠ°, ΠΏΡΠΈΠ·Π½Π°Π½Π½ΡΠΉ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΌ ΡΠ΅ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π°. Π€Π°ΠΊΡΠΎΡΠ°ΠΌΠΈ, ΡΠ²ΡΠ·Π°Π½Π½ΡΠΌΠΈ Ρ Π±ΠΎΠ»Π΅Π΅ Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΡΠΌ ΠΏΡΠΎΡΠ²Π»Π΅Π½ΠΈΠ΅ΠΌ ΡΠΈΠ±ΡΠΎΠ·Π° ΠΌΠΈΠΎΠΊΠ°ΡΠ΄Π°, ΠΎΠΊΠ°Π·Π°Π»ΠΈΡΡ ΠΆΠ΅Π½ΡΠΊΠΈΠΉ ΠΏΠΎΠ», ΡΡΠ°ΡΡΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°, ΠΌΠ°ΡΡΠ° ΡΠ΅Π»Π° ΠΏΠ°ΡΠΈΠ΅Π½ΡΠ°