Biventricular longitudinal strain analysis using CMR feature-tracking: prognostic value in Eisenmenger syndrome.

IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2024-10-28 DOI:10.1016/j.jocmr.2024.101116

Chao Gong, Chen Chen, Xuhan Liu, Ke Wan, Jiajun Guo, Juan He, Lidan Yin, Bi Wen, Shoufang Pu, Yucheng Chen Md

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引用次数: 0

Abstract

Background: Evidence to support risk stratification in Eisenmenger syndrome (ES) is still very limited. We hypothesized that biventricular longitudinal strain analysis could have potential prognostic value in ES.

Methods: We prospectively enrolled fifty-seven consecutive ES patients with post-tricuspid shunt who underwent both cardiovascular magnetic resonance (CMR) and right heart catheterization between June 2013 and March 2022. Biventricular longitudinal strains were evaluated by CMR feature-tracking analysis. The composite endpoint included all-cause mortality and re-admission for heart failure or hemoptysis. Cox regression analysis, Kaplan-Meier curves, and C-index were employed to assess the relationship between biventricular longitudinal strain and prognosis.

Results: During a median follow-up of 33 months (interquartile range: 12-50), 20 (35.1%) patients reached the composite endpoint. Patients with composite endpoints had significantly lower absolute values of left ventricular global longitudinal strain (LV GLS) and right ventricular free wall longitudinal strain (RV FWLS) than patients without composite endpoints (p < 0.05). Multivariate Cox regression analysis demonstrated that LV GLS and RV FWLS were independent predictors for composite endpoints (hazard ratio [HR]: 1.37, 95% confidence interval [CI]: 1.08-1.75, p = 0.010 and HR: 1.19, 95% CI: 1.01-1.41, p = 0.042). Kaplan-Meier analysis indicated that patients with both lower absolute values of LV GLS and RV FWLS were more likely to be at an even higher risk of composite endpoints (p < 0.001). Furthermore, the combined addition of LV GLS and RV FWLS provided incremental value for the prognostic model including clinical parameters and biventricular ejection fraction (C-index increased from 0.75 to 0.86, p = 0.004).

Conclusion: Impaired biventricular longitudinal strains improved prognostic prediction of ES patients with post-tricuspid shunt.

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利用 CMR 特征追踪进行双心室纵向应变分析：艾森曼格综合征的预后价值。

背景：支持艾森曼格综合征（ES）风险分层的证据仍然非常有限。我们假设双心室纵向应变分析可能对 ES 有潜在的预后价值：我们在 2013 年 6 月至 2022 年 3 月期间连续招募了 57 例三尖瓣分流术后 ES 患者，他们均接受了心血管磁共振（CMR）和右心导管检查。双心室纵向应变通过CMR特征追踪分析进行评估。综合终点包括全因死亡率和因心衰或咯血而再次入院。采用Cox回归分析、Kaplan-Meier曲线和C指数评估双心室纵向应变与预后之间的关系：中位随访33个月（四分位间范围：12-50个月），20名（35.1%）患者达到综合终点。达到综合终点的患者的左心室整体纵向应变（LV GLS）和右心室游离壁纵向应变（RV FWLS）的绝对值明显低于未达到综合终点的患者（P < 0.05）。多变量 Cox 回归分析表明，左心室 GLS 和右心室 FWLS 是综合终点的独立预测因子（危险比 [HR]：1.37，95% 置信区间 [HR]：1.37，95% 置信区间 [HR]：1.37）：1.37，95% 置信区间 [CI]：1.08-1.75，P = 0.010；HR：1.19，95% CI：1.01-1.41，P = 0.042）。Kaplan-Meier分析表明，左心室GLS和左心室FWLS绝对值均较低的患者发生复合终点的风险更高（p < 0.001）。此外，LV GLS 和 RV FWLS 的合并增加为包括临床参数和双心室射血分数在内的预后模型提供了增量价值（C 指数从 0.75 增加到 0.86，p = 0.004）：结论：双心室纵向应变受损改善了三尖瓣分流术后 ES 患者的预后预测。

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

Journal of Cardiovascular Magnetic Resonance 医学-核医学

CiteScore

10.90

自引率

12.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.