Right Ventricular Strain Derived from Cardiac MRI Feature Tracking for the Diagnosis and Prognosis of Arrhythmogenic Right Ventricular Cardiomyopathy.
IF 3.8
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Zhixiang Dong, Linlin Dai, Yanyan Song, Xuan Ma, Jiaxin Wang, Shiqin Yu, Shujuan Yang, Kai Yang, Kankan Zhao, Minjie Lu, Xiuyu Chen, Shihua Zhao
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引用次数: 0
Abstract
Purpose To demonstrate the myocardial strain characteristics of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC), based on revised Task Force Criteria (rTFC), and to explore the prognostic value of strain analysis in ARVC. Materials and Methods This retrospective study included 247 patients (median age, 38 years [IQR, 28-48 years]; 167 male, 80 female) diagnosed with ARVC, based on rTFC, between 2014 and 2018. Patients were divided into "possible" (n =25), "borderline" (n = 40), and "definite" (n = 182) ARVC groups following rTFC. Biventricular global strain parameters were calculated using cardiac MRI feature tracking (FT). The primary outcome was defined as a composite of cardiovascular events, including cardiovascular death, heart transplantation, and appropriate implantable cardioverter defibrillator discharge. Univariable and multivariable cumulative logistic regression and Cox proportional hazards regression analysis were used to evaluate the diagnostic and prognostic value of right ventricle (RV) strain parameters. Results Patients with definite ARVC had significantly reduced RV global strain in all three directions compared with possible or borderline groups (all P < .001). RV global longitudinal strain (GLS) was an independent predictor for disease (odds ratio, 1.09 [95% CI: 1.02, 1.16]; P = .009). During a median follow-up of 3.4 years (IQR, 2.0-4.9 years), 55 patients developed primary end point events. Multivariable analysis showed that RV GLS was independently associated with the occurrence of cardiovascular events (hazard ratio, 1.15 [95% CI: 1.07, 1.24]; P < .001). Kaplan-Meier analysis showed that patients with RV GLS worse than median had a higher risk of combined cardiovascular events (log-rank P < .001). Conclusion RV GLS derived from cardiac MRI FT demonstrated good diagnostic and prognostic value in ARVC. Keywords: MR Imaging, Image Postprocessing, Cardiac, Right Ventricle, Cardiomyopathies, Arrhythmogenic Right Ventricular Cardiomyopathy, Revised Task Force Criteria, Cardiovascular MR, Feature Tracking, Cardiovascular Events Supplemental material is available for this article. © RSNA, 2024.
从心脏磁共振成像特征追踪得出的右室应变用于诊断和预后致心律失常性右室心肌病
目的 根据修订的工作组标准(rTFC)展示心律失常性右室心肌病(ARVC)患者的心肌应变特征,并探讨应变分析在 ARVC 中的预后价值。材料与方法 这项回顾性研究纳入了 2014 年至 2018 年期间根据 rTFC 诊断为 ARVC 的 247 例患者(中位年龄 38 岁 [IQR,28-48 岁];男性 167 例,女性 80 例)。根据rTFC将患者分为 "可能"(25人)、"边缘"(40人)和 "明确"(182人)ARVC组。使用心脏磁共振成像特征跟踪(FT)计算双心室整体应变参数。主要结果定义为心血管事件的复合结果,包括心血管死亡、心脏移植和适当的植入式心脏除颤器放电。采用单变量和多变量累积逻辑回归及Cox比例危险回归分析来评估右心室(RV)应变参数的诊断和预后价值。结果 与可能组或边缘组相比,确诊为 ARVC 的患者在所有三个方向上的 RV 整体应变都明显降低(均 P < .001)。RV整体纵向应变(GLS)是疾病的独立预测因子(几率比:1.09 [95% CI:1.02, 1.16];P = .009)。在中位随访 3.4 年(IQR:2.0-4.9 年)期间,55 名患者出现了主要终点事件。多变量分析显示,RV GLS 与心血管事件的发生有独立关联(危险比为 1.15 [95% CI: 1.07, 1.24];P < .001)。Kaplan-Meier 分析显示,RV GLS 低于中位数的患者合并心血管事件的风险更高(对数秩 P < .001)。结论 由心脏磁共振成像 FT 得出的 RV GLS 对 ARVC 具有良好的诊断和预后价值。关键词磁共振成像,图像后处理,心脏,右心室,心肌病,致心律失常右室心肌病,修订工作组标准,心血管磁共振,特征追踪,心血管事件 本文有补充材料。© RSNA, 2024.
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