左心室收缩功能保留患者整体纵向应变的预后价值：一项心脏磁共振真实世界研究。

IF 4.2 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiovascular Magnetic Resonance Pub Date : 2024-07-04 DOI:10.1016/j.jocmr.2024.101057

Preeyaporn Janwetchasil, Ahthit Yindeengam, Rungroj Krittayaphong

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引用次数: 0

摘要

背景：心肌应变是比左心室射血分数（LVEF）更敏感的心功能评估参数。本研究旨在通过特征追踪-心脏磁共振（FT-CMR）成像评估左心室整体纵向应变（LV-GLS）在已知或疑似冠状动脉疾病（CAD）且左心室收缩功能保留的患者中的预测价值：这项回顾性队列分析纳入了2017年9月至2019年12月期间接受CMR成像的已知或疑似CAD患者。通过特征追踪分析对 LV-GLS 进行分析。患者的 LVEF 结果：共有2613名患者。平均随访时间为（39.7±13.9）个月。随访期间，194 名患者（7.4%）出现了综合结果。根据Receiver-Operating-Characteristics，LV-GLS预测综合结果的最佳临界值为-14.4%。根据 LV-GLS 将患者分为两组；1,489 例（57.0%）患者有 LV GLS 结论：FT-CMR 的 LV-GLS 被证明有助于预测左心室收缩功能保留的已知或疑似 CAD 患者的预后。LV-GLS -14.4%是确定预后的临界值。

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Prognostic value of global longitudinal strain in patients with preserved left ventricular systolic function: A cardiac magnetic resonance real-world study.

Background: Myocardial strain is a more sensitive parameter for cardiac function evaluation than left ventricular ejection fraction (LVEF). This study aimed to assess the predictive value of left ventricular global longitudinal strain (LV-GLS) by feature tracking-cardiac magnetic resonance (FT-CMR) imaging in patients with known or suspected coronary artery disease (CAD) with preserved left ventricular systolic function.

Methods: This retrospective cohort analysis enrolled patients with known or suspected CAD who underwent cardiac magnetic resonance imaging from September 2017 to December 2019. LV-GLS was analyzed via feature-tracking analysis. Patients with LVEF <50% were excluded. The composite outcome comprised all-cause death, non-fatal myocardial infarction, and heart failure.

Results: There was a total of 2613 patients. Mean follow-up duration was 39.7 ± 13.9 months. During follow-up, 194 patients (7.4%) experienced a composite outcome. The best cutoff of LV-GLS in the prediction of composite outcome from receiver operating characteristics was -14.4%. Patients were classified into 2 groups according to the LV-GLS; 1489 (57.0%) had LV-GLS <-14.4% and 1124 (43.0%) had LV-GLS ≥-14.4%. Patients with LV-GLS ≥-14.4% had a significantly higher rate of composite outcome than LV-GLS <-14.4% patients (3.59 vs. 1.39 per 100 person-years, respectively; p < 0.001). Multivariable analysis showed that patients with LV-GLS ≥-14.4% had a significantly higher risk of experiencing a composite outcome event compared to global longitudinal strain <-14.4% patients (adjusted hazard ratio: 1.83, 95% confidence interval: 1.28-2.61; p = 0.001).

Conclusion: LV-GLS by FT-CMR was shown to be useful for predicting the prognosis of patients with known or suspected CAD with preserved left ventricular systolic function. LV-GLS -14.4% was the identified cutoff for prognostic determination.

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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.