Lung water density is increased in patients at risk of heart failure and is largely independent of conventional CMR measures

IF 5.4 3区材料科学 Q2 CHEMISTRY, PHYSICAL

ACS Applied Energy Materials Pub Date : 2024-06-01 DOI:10.1101/2024.05.31.24308269

N. R. Iyer, J. A. Bryant, Thu-Thao Le, J. G. Grenier, R. B. Thompson, C. W. Chin, M. Ugander

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Abstract

Aims: Non-invasive methods to quantify pulmonary congestion are lacking in clinical practice. Cardiovascular magnetic resonance (CMR) lung water density (LWD) mapping is accurate, reproducible, and has prognostic value. However, it is not known whether LWD is associated with routinely acquired CMR parameters. Methods and Results: This was a prospective, observational cohort including healthy controls and patients at risk of heart failure. Lung water density was measured using CMR with a free-breathing short echo time 3D cartesian gradient-echo sequence with a respiratory navigator at 1.5T. Associations were assessed between LWD, lung water volume (LWV) and cardiac volumes, left ventricular (LV) mass and function, myocardial native T1 and extracellular volume fraction (ECV). In patients at risk for heart failure (n=155), LWD was greater than in healthy controls (n=15) (30.4{+/-}5.0 vs 27.2{+/-}4.3%, p=0.02). Using receiver operating characteristic analysis, the optimal cut-off for LWD was 27.6% to detect at-risk patients (sensitivity 72%, specificity 73%, positive likelihood ratio 2.7, inverse negative likelihood ratio 2.6). LWD was univariably associated with body mass index (BMI), hypertension, right atrial (RA) area and LV mass (p<0.05 for all). In multivariable linear regression, only BMI remained associated with LWD (R2=0.32, p<0.001). In a separate multivariable analysis including only CMR markers, only RA area remained associated with LWD (R2=0.05, p=0.006). Conclusion: LWD is increased in patients at risk for heart failure compared to controls, and is only weakly explained by conventional CMR measures. LWD provides diagnostic information which is largely independent of conventional CMR measures.

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有心力衰竭风险的患者肺水密度会升高，这在很大程度上与常规 CMR 测量无关

目的：临床实践中缺乏量化肺充血的无创方法。心血管磁共振（CMR）肺水肿密度（LWD）绘图准确、可重复，并具有预后价值。然而，LWD 是否与常规获得的 CMR 参数相关尚不清楚。方法和结果：这是一项前瞻性观察性队列研究，包括健康对照组和有心力衰竭风险的患者。在 1.5T 下使用带有呼吸导航仪的自由呼吸短回波时间三维笛卡尔梯度回波序列进行 CMR 测量肺水密度。评估了肺水密度、肺水容积（LWV）与心脏容积、左心室（LV）质量和功能、心肌原生T1和细胞外容积分数（ECV）之间的关系。在有心力衰竭风险的患者（155 人）中，肺活量大于健康对照组（15 人）（30.4{+/-}5.0 vs 27.2{+/-}4.3%，P=0.02）。通过接收器操作特征分析，LWD 的最佳临界值为 27.6%，可检测出高危患者（灵敏度 72%，特异度 73%，正向似然比 2.7，反向负向似然比 2.6）。LWD与体重指数（BMI）、高血压、右心房（RA）面积和左心室质量存在单变量相关性（均为P<0.05）。在多变量线性回归中，只有体重指数仍与 LWD 相关（R2=0.32，P<0.001）。在仅包括 CMR 标记的单独多变量分析中，只有 RA 面积仍与 LWD 相关（R2=0.05，P=0.006）。结论与对照组相比，心力衰竭高危患者的 LWD 会增加，而传统的 CMR 测量只能提供微弱的解释。LWD 提供的诊断信息在很大程度上独立于传统的 CMR 测量。

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来源期刊

ACS Applied Energy Materials Materials Science-Materials Chemistry

CiteScore

10.30

自引率

6.20%

发文量

1368

期刊介绍： ACS Applied Energy Materials is an interdisciplinary journal publishing original research covering all aspects of materials, engineering, chemistry, physics and biology relevant to energy conversion and storage. The journal is devoted to reports of new and original experimental and theoretical research of an applied nature that integrate knowledge in the areas of materials, engineering, physics, bioscience, and chemistry into important energy applications.