İzole sol ventrikül noncompaction olan hastalarda miyokard dokusunun analizi

Year 2019, , 33 - 41, 21.03.2019

Sefa Ünal , Burak Açar , Çağrı Yayla , Ahmet Göktuğ Ertem , Omaç Tüfekçioğlu Dursun Aras

https://doi.org/10.18663/tjcl.517548

Abstract

Amaç: Videodensitometrik miyokardiyal doku analizi (VMTA), çeşitli
kardiyak hastalıklarda sol ventrikül (LV) disfonksiyonunu araştırmak için
yaygın olarak kullanılmıştır. İzole sol ventrikül  noncompaction (IVNC) olan hastalar LV
fonksiyonunda dalgalı bir düşüş yaşarlar. Bu çalışmanın amacı, bu hasta
grubunda LV fonksiyonunun bozulmasını değerlendirmek için VMTA değerini
değerlendirmektir.

 

Gereç ve Yöntemler: IVNC'li 25 hasta (10 asemptomatik [korunmuş LV fonksiyonu], 12
semptomatik [LV disfonksiyon]) ve 12 sağlıklı kontrol olacak şekilde
değerlendirildi. Sistol sonunda ve diyastolde orta bazal LV duvarının 2 bölgesi
(interventriküler septum [IVS] ve arka duvar [PW]) için arka plan düzeltmeli
ortalama gri seviyelerini (BC-MGL) kaydetmek için videodensitometri kullanıldı.
Her bölge için siklik varyasyon (CV) indeksi, formül CV'ye göre
hesaplandı,  CV indeksi, % = ([[BC-MGL_end-diastol
- BC-MGL _end-sistol]] ÷ BC- MGL_end-diastol) × 100.

 

Bulgular: Semptomatik IVNC grubundaki ortalama IVS-CV indeksi (% 12.3 ± 4.9),
asemptomatik IVNC grubundaki (% 32.3 ± 14.8; p <0.05) ve kontrol grubundaki
(% 36.6 ± 12.1) karşılık gelen bulgulardan anlamlı olarak düşüktü (p
<0.001). Semptomatik gruptaki ortalama PW-CV indeksi (% 15.1 ± 5.5),
asemptomatik (27.0 ± 10.4; p <0.05) ve kontrol gruplarındaki (28.8 ± 10.9; p
<0.001) karşılık gelen değerlerden anlamlı olarak düşüktü.

 

Sonuç: VMTA, IVNC'li hastalarda LV miyokardiyumu değerlendirmek için
konvansiyonel ekokardiyografiye pratik ve faydalı bir yardımcıdır. Azaltılmış
CV indeks değerlerinin tespiti, bu grupta LV bozulmasının erken aşamalarını
öngörebilir.

Keywords

videodensitometrik miyokardiyal doku analizi, izole sol ventrikül noncompaction kardiyomiyopati, kalp yetmezliği;, non-invaziv kalp görüntüleme

Analysis of myocardial texture in patients with isolated left ventricular noncompaction

Abstract

Aim: Videodensitometric myocardial texture analysis (VMTA)
has been widely used to investigate left ventricular (LV) dysfunction in
various cardiac disorders. Patients with isolated left ventricular
noncompaction (IVNC) experience an undulating decline in LV function. The aim of
this study was to assess the value of VMTA for evaluating deterioration of LV function in this patient group.

Material
and Methods: Twenty-two patients with IVNC (10 asymptomatic
[preserved LV function], 12 symptomatic [LV dysfunction]) and 12 healthy
controls were evaluated. Videodensitometry was used to record background-corrected mean gray levels
(BC-MGL) for 2 regions of the mid-basal LV wall (the interventricular
septum [IVS] and the posterior wall [PW]) at end-systole and end-diastole. The
cyclic variation (CV) index for each region was calculated according to the
formula, CV index % = ([BC-MGL_end-diastole – BC-MGL_end-systole]
÷ BC-MGL_end-diastole) × 100.

Results:
The mean IVS-CV index in the symptomatic IVNC group (12.3 ± 4.9%) was significantly lower than the
corresponding findings in the asymptomatic IVNC group (32.3 ± 14.8%,
p < 0.05) and control group (36.6 ± 12.1%, p < 0.001). The mean PW-CV
index in the symptomatic group (15.1 ± 5.5%) was also significantly
lower than the corresponding values in the asymptomatic (27.0 ± 10.4%,
p < 0.05) and
control groups (28.8 ± 10.9%, p < 0.001).

Conclusion: VMTA is a practical, useful adjunct to conventional echocardiography for assessing LV
myocardium in patients with IVNC. Detection of reduced CV index values might
predict the early stages of LV deterioration in this group.

Keywords

videodensitometric myocardial texture analysis, isolated left ventricular noncompaction, cardiomyopathy, non-invasive cardiac imaging

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