Association Between Late Gadolinium Enhancement with or Without Reverse Remodeling and Prognosis.

IF 1.2 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Toshinaru Kawakami, Kazuyuki Yahagi, Asahi Oshima, Yuki Gonda, Daiki Yoshiura, Yu Horiuchi, Masahiko Asami, Hitomi Yuzawa, Kota Komiyama, Jun Tanaka, Jiro Aoki, Kengo Tanabe
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Abstract

Late gadolinium enhancement (LGE) in cardiovascular magnetic resonance imaging (CMR) prevents left ventricular reverse remodeling (LVRR), resulting in a poor prognosis. However, the prognosis of patients who have LGE and achieve LVRR and patients who do not have LGE and do not achieve LVRR remains unknown. This study aimed to answer this question by sorting patients with heart failure based on the presence of LGE and LVRR and comparing their prognoses. Another aim was to identify useful factors for predicting LVRR.All patients were followed-up for 24 months. LVRR was defined as a ≥ 10% increase at the last follow-up at 12 ± 6 months from baseline, on echocardiography. The primary endpoint was a composite of cardiovascular death and hospitalization due to worsening heart failure within 18 ± 6 months. Baseline data and data from each outpatient visit were collected and analyzed. We enrolled 80 consecutive patients with heart failure and reduced left ventricular ejection fraction (< 50%) who underwent CMR.LGE was positive in 40 patients (50.0%) and LVRR was observed in 50 patients (63%). The incidence of the primary endpoint was significantly lower in the group that achieved LVRR, regardless of LGE status (LGE-positive group, P = 0.01; LGE-negative group, P = 0.02). In the multivariate analysis, the percentage change in NT-pro BNP levels at 3 months, NT-pro BNP levels at 6 months, and age were independent predictors of LVRR.LGE-positive patients may have a better prognosis if they achieve LVRR. Serial NT-pro BNP testing may be a valuable predictor of LVRR.

伴有或不伴有逆重塑的晚期钆增强与预后之间的关系
心血管磁共振成像(CMR)中的晚期钆增强(LGE)可阻止左心室反向重塑(LVRR),导致不良预后。然而,有 LGE 并达到左心室反向重塑的患者与没有 LGE 也没有达到左心室反向重塑的患者的预后仍不清楚。本研究旨在回答这一问题,根据 LGE 和 LVRR 的存在对心衰患者进行分类,并比较他们的预后。另一个目的是确定预测 LVRR 的有用因素。LVRR的定义是:在最后一次随访时,即12±6个月时,超声心动图检查结果比基线增加≥10%。主要终点是心血管死亡和在 18±6 个月内因心衰恶化住院的复合终点。我们收集并分析了基线数据和每次门诊的数据。我们连续招募了80名左心室射血分数降低(小于50%)的心衰患者进行CMR检查。40名患者(50.0%)LGE呈阳性,50名患者(63%)观察到LVRR。无论 LGE 状态如何,达到 LVRR 的患者组主要终点的发生率明显较低(LGE 阳性组,P = 0.01;LGE 阴性组,P = 0.02)。在多变量分析中,3 个月时的 NT-pro BNP 水平变化百分比、6 个月时的 NT-pro BNP 水平和年龄是 LVRR 的独立预测因素。连续的 NT-pro BNP 检测可能是预测 LVRR 的重要指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International heart journal
International heart journal 医学-心血管系统
CiteScore
2.50
自引率
6.70%
发文量
148
审稿时长
6-12 weeks
期刊介绍: Authors of research articles should disclose at the time of submission any financial arrangement they may have with a company whose product figures prominently in the submitted manuscript or with a company making a competing product. Such information will be held in confidence while the paper is under review and will not influence the editorial decision, but if the article is accepted for publication, the editors will usually discuss with the authors the manner in which such information is to be communicated to the reader.
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