CMR-based T2 RV/LV blood pool ratio: Help for risk stratification in heart failure

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-05-15 DOI:10.1016/j.ejrad.2025.112178

Siying Ma, Junjie Zhou, Cailing Pu, Fuyan Wang, Qiuhui Hu, Yan Wu, Feidan Yu, Lingjie Zhang, Chengbin He, Hongjie Hu

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引用次数: 0

Abstract

Objectives

Blood pool signals on T2 map can reflect intracardiac blood oxygenation. This study aimed to evaluate the T2 RV/LV blood pool ratio (T2 ratio) as a potential parameter for risk stratification in heart failure (HF) patients.

Methods

217 HF patients undergoing cardiac MRI were categorized into major adverse cardiovascular events (MACE) and No MACE groups. Regions of interest were delineated in the bi-ventricular blood pools on T2 maps to calculate T2 ratios. Clinical and imaging parameters were compared between groups, and independent predictors of MACE were identified using Cox regression analysis. Associations between T2 ratios and other parameters were explored. Survival analyses were conducted across low, moderate, and high-risk groups. Finally, predictive performance for MACE was compared among different models.

Results

The T2 ratio was lower in MACE group (0.65 ± 0.12 vs 0.75 ± 0.12, P < 0.001) and was identified as an independent prognostic predictor of adverse outcomes in HF (HR: 0.966, P = 0.044). The association between T2 ratio and left ventricular ejection fraction (LVEF) followed distinct patterns in different ranges, with a transition around LVEF ≈ 50 %. Survival analysis demonstrated a stepwise decline in event-free survival from low- to high-risk groups (P < 0.05). Finally, the predictive model G incorporating myocardial T1 and T2 ratio demonstrated superior predictive efficacy (C-statistic: 0.806, IBS: 0.087).

Conclusions

A lower T2 ratio was associated with a higher risk of MACE in HF patients. This parameter may serve as a valuable tool for risk stratification in clinical practice.

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基于cmr的T2左室/左室血池比：有助于心衰的风险分层

目的血池信号在T2图上反映心内血氧变化。本研究旨在评估T2左室/左室血池比率（T2比率）作为心衰（HF）患者风险分层的潜在参数。方法217例HF患者行心脏MRI检查，分为重大心血管不良事件（MACE）组和无MACE组。在T2图上的双心室血池中划定感兴趣的区域以计算T2比率。比较两组患者的临床和影像学参数，并采用Cox回归分析确定MACE的独立预测因素。探讨了T2比率与其他参数之间的关系。对低、中、高风险组进行生存分析。最后，比较了不同模型对MACE的预测性能。结果MACE组T2比值较MACE组低(0.65±0.12 vs 0.75±0.12,P <；0.001)，被认为是心衰不良结局的独立预后预测因子（HR: 0.966, P = 0.044）。T2比值与左室射血分数（LVEF）的相关性在不同范围内具有不同的模式，在LVEF≈50%附近发生转变。生存分析显示，从低危组到高危组，无事件生存率逐步下降(P <；0.05)。最后，结合心肌T1和T2比值的预测模型G具有较好的预测效果（c -统计量：0.806,IBS: 0.087）。结论心衰患者T2比值越低，MACE发生风险越高。在临床实践中，该参数可作为风险分层的有价值工具。

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

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.