健康成人CT特征追踪左心室心肌应变参考值
本研究回顾性纳入128例无已知心血管病及危险因素的健康成人，行冠状动脉CT血管成像后以CT特征追踪评估左心室整体与节段心肌应变。结果显示整体纵向、圆周、径向应变存在性别差异，女性绝对值高于男性；不同层面和节段应变大小不一。整体应变测量可重复性良好，ICC为0.836-0.918。
要点
- 左心室整体纵向、圆周、径向应变存在性别差异，阅片参考时应区分男女。
- 心尖层面纵向与圆周应变绝对值在三个左心室层面中最高。
- 整体纵向与圆周应变与性别及LVEF相关，整体径向应变仅与LVEF相关。
核心结论
- 健康成人CT-FT获得的左心室整体心肌应变具有性别依赖性，女性整体纵向、圆周、径向应变绝对值均大于男性。
- 左心室心肌应变在不同层面和区域存在差异，心尖层面纵向与圆周应变绝对值最高。
研究设计与样本
- 回顾性研究，纳入128例接受冠状动脉CT血管成像的健康参与者，男性47例，女性81例，中位年龄50.5（47.0-57.0）岁。
- 所有参与者均无已知心血管疾病和潜在心血管危险因素。
- 评估指标为整体及区域左心室应变，包括纵向应变、圆周应变和径向应变。
关键影像表现/征象
- 心尖层面的纵向应变与圆周应变在三个左心室层面中绝对值最大。
- 纵向应变与径向应变绝对值在侧壁区域最大。
- 圆周应变绝对值在室间隔区域最大。
诊断标准与关键数值
- 整体左心室心肌应变测量重复性良好，组内相关系数范围为0.836-0.918。
- 女性整体纵向应变、整体圆周应变、整体径向应变绝对值均大于男性，所有P<0.05。
- 性别和LVEF与整体纵向应变及整体圆周应变相关，所有P<0.001。
- 仅LVEF与整体径向应变相关，P<0.001。
临床应用与阅片要点
- 使用CT-FT测量左心室心肌应变时，应结合性别和LVEF解读整体纵向与圆周应变结果。
- 评估节段应变时需注意心尖层面及侧壁、室间隔区域的正常变异。
局限性
- 本研究为回顾性设计。
- 研究对象为健康成人，结果向其他人群外推需谨慎。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
AIM: To determine the reference value of left ventricular (LV) myocardial strain in healthy subjects using cardiac computed tomography feature tracking (CT-FT).
MATERIALS AND METHODS: This study retrospectively enrolled 128 healthy participants who underwent coronary CT angiography. All participants were free of known cardiovascular diseases and potential cardiovascular risk factors. Global and regional LV strain metrics, including longitudinal strain (LS), circumferential strain (CS), and radial strain (RS), were assessed.
RESULTS: The entire cohort included 47 men and 81 women, and the median age was 50.5 (47.0-57.0) years. There was no significant difference of age between females and males (P>0.05). Females demonstrated larger magnitudes of global LS, global CS, and global RS than males (all P<0.05). The LS in the apical slice and CS in the apical slice exhibited the highest magnitudes among the three LV slices. The largest magnitudes of LS and RS were observed in the lateral region, whereas the largest magnitude of CS was demonstrated in the septal region. The gender and LV ejection fraction (LVEF) were associated with global LS and global CS (all P<0.001), whereas only LVEF demonstrated the association with global RS (P<0.001). The global LV myocardial strain demonstrated good measurement reproducibility with intraclass correlation coefficients ranging from 0.836-0.918.
CONCLUSION: The global LV myocardial strain derived from CT-FT in healthy participants is sex-dependent; the LV myocardial strain varies in different levels and regions.
引用
- He, Tang, Yang, et al. Reference value of left ventricular myocardial strain by computed tomography feature tracking in healthy adults. Clin Radiol. 2026. PMID: 42407294. doi:10.1016/j.crad.2026.107360
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。