丰坦手术后患者心脏磁共振成像参数的特征和 Z 评分计算。使用CMR检查的丰坦结果登记(FORCE)研究。

IF 4.2 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Tarek Alsaied, Runjia Li, Adam Christopher, Mark Fogel, Timothy C Slesnick, Rajesh Krishnamurthy, Vivek Muthurangu, Adam L Dorfman, Christopher Z Lam, Justin Weigand, Jong-Hyeon Jeong, Joshua D Robinson, Laura J Olivieri, Rahul H Rathod
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引用次数: 0

摘要

背景:心脏磁共振(CMR)可提供有价值的丰坦术后血液动力学信息,但由于缺乏标准单心室数据而受到限制。使用CMR检查的丰坦结果登记处(FORCE)是一个大型国际性丰坦专用CMR登记处。本研究利用FORCE登记数据评估预期的CMR心室大小/功能,并根据心室形态(VM)调整较健康的Fontan患者的心室大小/功能,创建Fontan特异性z分数:方法:"更健康 "的Fontan患者被定义为无不良后果、纽约心脏协会I级、瓣膜疾病轻微或较轻的患者:较健康 "的丰坦患者包括来自 18 家机构的 885 名患者(15.0 ± 7.6 岁),共进行了 1,156 次 CMR 检查。与右心室或混合型(双心室)形态的患者相比,左心室形态的患者容积、质量较小,射血分数(EF)较高(p结论:该研究首次生成了CMR数据,并对其进行了分析:这是第一项生成方坦术后 CMR z 评分的研究。重要的是,Z 值是在 "较健康 "的丰坦患者以及儿童和成人丰坦患者中生成和测试的。这些方程可能会改善丰坦术后基于 CMR 的风险分层。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Characterization and Z-score Calculation of Cardiac MRI parameters in patients after the Fontan operation. A Fontan Outcome Registry using CMR Examinations (FORCE) study.

Background: Cardiac magnetic resonance (CMR) offers valuable hemodynamic insights post-Fontan, but is limited by the absence of normative single ventricle data. The Fontan Outcomes Registry using CMR Examinations (FORCE) is a large international Fontan-specific CMR registry. This study used FORCE registry data to evaluate expected CMR ventricular size/function and create Fontan-specific z-scores adjusting for ventricular morphology (VM) in healthier Fontan patients.

Methods: "Healthier" Fontan patients were defined as patients free of adverse outcomes, who are New York Heart Association Class I, have mild or less valve disease, and <30% aortopulmonary collateral burden. General linear modeling was performed on 70% of the dataset to create z-scores for volumes and function. Models were tested using the remainder (30%) of the data. The z-scores were compared between children and adults. The z-scores were also compared between "healthier" Fontan and patients with adverse outcomes (death, listing for transplantation or multiorgan disease).

Results: The "healthier" Fontan population included 885 patients (15.0 ± 7.6 years) from 18 institutions with 1,156 CMR examinations. Patients with left ventricle morphology had lower volume, mass and higher ejection fraction (EF) compared to right or mixed (two-ventricles) morphology (p<0.001 for all pairwise comparisons). Gender, BSA and VM were used in z-scores. Of the "healthier" Fontan patients, 647 were children <18 years and 238 were adults. Adults had lower ascending aorta flow (2.9 ± 0.7 vs 3.3 ± 0.8L/min/m2, p<0.001) and ascending aorta flow z-scores (-0.16 ± 1.23 vs 0.05 ± 0.95, 0.02) compared to children. Additionally, there were 1595 patients with adverse outcomes who were older (16.1 ± 9.3 vs 15.0 ± 7.6, p<0.001) and less likely to have LV morphology (35 vs 47%, p<0.001). Patients with adverse outcomes had higher z-scores for ventricular volume and mass and lower z-scores for EF and ascending aorta flow compared to the "healthier" Fontan cohort.

Conclusion: This is the first study to generate CMR z-scores post-Fontan. Importantly the z-scores were generated and tested in "healthier" Fontan patients and both pediatric and adult Fontan patients. These equations may improve CMR-based risk stratification after the Fontan operation.

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来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
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.
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