基于心脏磁共振的周长面积比在慢性肺血栓栓塞症心室重构中的价值OA

Objective This study aims to investigate the value of the perimeter-area ratio(PAR)derived from non-contrast cardiac magnetic resonance(CMR)imaging in assessing ventricular remodeling and risk stratifi-cation in patients with chronic pulmonary thromboembolism(CPTE).Methods A total of 53 patients with CPTE were prospectively enrolled,including 16 with chronic thromboembolic pulmonary disease(CTEPD)and 37 with chronic thromboembolic pulmonary hypertension(CTEPH).Additionally,53 age-and sex-matched healthy volun-teers were recruited as controls.All patients underwent CMR and right heart catheterization within 24 hours.Biven-tricular PAR values were calculated and compared among the three groups at three short-axis levels on end-diastolic and end-systolic cine images.Diagnostic performance was assessed using receiver operating characteristic curve analysis,and associations between PAR and hemodynamic parameters were examined using Spearman's cor-relation.Results Compared with CTEPD patients,right ventricular(RV)PAR was significantly lower in CTEPH patients,with the most pronounced difference observed at the apical level(P＜0.05).At this level,RV-PAR dem-onstrated excellent diagnostic performance in identifying CPTE and distinguishing its subtypes,with area under the curve(AUC)values ranging from 0.872 to 0.990,along with high sensitivity and specificity.RV-PAR was nega-tively correlated with afterload indices and positively correlated with perfusion and output parameters(all P＜0.05).Conclusions CMR-derived PAR sensitively captures microstructural remodeling of the right ventricle in CPTE patients,serving as a potential non-invasive biomarker for disease severity assessment and risk stratification.Notably,the cardiac apex emerges as the most sensitive region for adaptive changes in the right ventricle.