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已发表论文
CMR 特征追踪和 T1 Mapping 揭示高血压性心脏病中以心尖部为主的心肌纤维化
Authors Cheng J, Xie C, Pan L, Hu X, Lv X, Yu D, Li Y, Liao J
Received 20 October 2025
Accepted for publication 20 January 2026
Published 7 February 2026 Volume 2026:19 575589
DOI https://doi.org/10.2147/IJGM.S575589
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Redoy Ranjan
Jihao Cheng,1,* Chunmei Xie,2,* Luhang Pan,3 Xixin Hu,2 Xiaoqing Lv,2 Dehong Yu,2 Yichao Li,2 Jingyun Liao2
1Department of Radiology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, People’s Republic of China; 2Department of Radiology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311200, People’s Republic of China; 3Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jingyun Liao, Department of Radiology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, No. 728, Yucai North Road, Xiaoshan District, Hangzhou, 310005, People’s Republic of China, Tel +86-0571-85267191, Email ljy943425997@126.com
Objective: To evaluate the utility of cardiac magnetic resonance feature tracking (CMR-FT) and T1 mapping in quantifying myocardial injury in early hypertensive heart disease, focusing on segmental parameter differences.
Methods: A total of 156 hypertensive patients were enrolled and divided into a left ventricular hypertrophy (LVH) group (n=63) and a non-hypertrophy (Non-LVH) group (n=93) based on the left ventricular mass index (LVMI). All patients underwent CMR examination. Left ventricular function, myocardial strain, global and segmental native T1 values, and extracellular volume (ECV) were obtained using post-processing software. Parameters were compared between the two groups, with special attention to differences among myocardial segments to identify regional characteristics of fibrosis distribution.
Results: Compared with the Non-LVH group, the LVH group showed significantly lower absolute values of global longitudinal strain (GLS; median: − 10.80% vs − 15.75%), global circumferential strain (GCS), and global radial strain (GRS) (all P < 0.05), while global native T1 (median: 1080 ms vs 1036 ms) and ECV (median: 29.8% vs 27.0%) were significantly elevated (P < 0.05). Notably, myocardial fibrosis exhibited an apical-predominant distribution pattern, with the most significant parameter differences observed in the apical segments. For instance, in the LVH group, ECV in the apical septal segment (segment 14) was significantly higher [33.50% (30.40, 36.15) vs 26.70% (26.70, 27.90) in Non-LVH, P=0.001], and native T1 in the apical anterior segment (segment 13) was elevated [1105.65 ± 72.31 ms vs 1039.80 ± 47.77 ms, P=0.006], suggesting a possible apical-predominant pattern of myocardial fibrosis.These changes correlated with high diagnostic accuracy for LVH: GLS showed the highest AUC (0.91) in ROC analysis. In the LVH group, global ECV positively correlated with native T1 and LGE positivity, and negatively with GCS and GLS (P < 0.05).
Conclusion: CMR-FT and T1 Mapping techniques can effectively and quantitatively assess myocardial injury and fibrosis in hypertensive patients. Global longitudinal strain (GLS) is a sensitive parameter for diagnosing left ventricular hypertrophy (LVH), and myocardial fibrosis in patients with hypertension-induced LVH exhibits an apical-predominant distribution pattern.This spatial pattern, if validated prospectively, could serve as a potential imaging biomarker for monitoring in hypertensive patients.
Keywords: cardiac magnetic resonance feature tracking, myocardial strain, hypertension, left ventricular hypertrophy, LVH, T1 mapping, extracellular volume, ECV
1Department of Radiology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, People’s Republic of China; 2Department of Radiology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, 311200, People’s Republic of China; 3Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jingyun Liao, Department of Radiology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, No. 728, Yucai North Road, Xiaoshan District, Hangzhou, 310005, People’s Republic of China, Tel +86-0571-85267191, Email ljy943425997@126.com
Objective: To evaluate the utility of cardiac magnetic resonance feature tracking (CMR-FT) and T1 mapping in quantifying myocardial injury in early hypertensive heart disease, focusing on segmental parameter differences.
Methods: A total of 156 hypertensive patients were enrolled and divided into a left ventricular hypertrophy (LVH) group (n=63) and a non-hypertrophy (Non-LVH) group (n=93) based on the left ventricular mass index (LVMI). All patients underwent CMR examination. Left ventricular function, myocardial strain, global and segmental native T1 values, and extracellular volume (ECV) were obtained using post-processing software. Parameters were compared between the two groups, with special attention to differences among myocardial segments to identify regional characteristics of fibrosis distribution.
Results: Compared with the Non-LVH group, the LVH group showed significantly lower absolute values of global longitudinal strain (GLS; median: − 10.80% vs − 15.75%), global circumferential strain (GCS), and global radial strain (GRS) (all P < 0.05), while global native T1 (median: 1080 ms vs 1036 ms) and ECV (median: 29.8% vs 27.0%) were significantly elevated (P < 0.05). Notably, myocardial fibrosis exhibited an apical-predominant distribution pattern, with the most significant parameter differences observed in the apical segments. For instance, in the LVH group, ECV in the apical septal segment (segment 14) was significantly higher [33.50% (30.40, 36.15) vs 26.70% (26.70, 27.90) in Non-LVH, P=0.001], and native T1 in the apical anterior segment (segment 13) was elevated [1105.65 ± 72.31 ms vs 1039.80 ± 47.77 ms, P=0.006], suggesting a possible apical-predominant pattern of myocardial fibrosis.These changes correlated with high diagnostic accuracy for LVH: GLS showed the highest AUC (0.91) in ROC analysis. In the LVH group, global ECV positively correlated with native T1 and LGE positivity, and negatively with GCS and GLS (P < 0.05).
Conclusion: CMR-FT and T1 Mapping techniques can effectively and quantitatively assess myocardial injury and fibrosis in hypertensive patients. Global longitudinal strain (GLS) is a sensitive parameter for diagnosing left ventricular hypertrophy (LVH), and myocardial fibrosis in patients with hypertension-induced LVH exhibits an apical-predominant distribution pattern.This spatial pattern, if validated prospectively, could serve as a potential imaging biomarker for monitoring in hypertensive patients.
Keywords: cardiac magnetic resonance feature tracking, myocardial strain, hypertension, left ventricular hypertrophy, LVH, T1 mapping, extracellular volume, ECV