左心室重构指数预测射血分数< 35的扩张型心肌病室性心动过速。

IF 4.5 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-08-29 DOI:10.1186/s13244-025-02059-6

Xi Jia, Weipeng Yan, Xuan Ma, Zhixiang Dong, Jiaxin Wang, Shujuan Yang, Kankan Zhao, Zhuxin Wei, Yun Tang, Pengyu Zhou, Xingrui Chen, Yujie Liu, Xiuyu Chen, Shihua Zhao

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引用次数: 0

摘要

目的：评估扩张型心肌病（DCM）合并左室射血分数（LVEF）患者左室重构指数（LVRI）对室性心动过速（VTA）的预测作用。材料和方法：在本回顾性单中心研究中，连续DCM合并LVEF患者结果：超过71个月的中位随访（四分位数范围：17-134个月），35名（12.9%，平均年龄46.7岁，27名男性）参与者达到VTA事件。晚期钆增强（LGE）和LVEF（23.3±6比21.9±10.3,p = 0.197）的存在（62.9%比60.2%,p = 0.761）和程度（6.9±6.6比6.5±8.3,p = 0.747）在有无终点患者之间无显著差异。Kaplan-Meier曲线分析显示LVRI≥7.5的参与者更有可能经历VTA (p)结论：对于非缺血性DCM患者合并LVEF的关键相关性声明：左室重构指数（LVRI）与扩张型心肌病合并LVEF患者的室性心动过速独立相关关键点：左室射血分数对终末期扩张型心肌病患者没有显着的预后价值。心脏MRI （CMR）评估的左心室重构指数(LVRI)≥7.5是室性心动过速的独立预测因子。与传统CMR参数相比，LVRI提供了增加的预后价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

$Left ventricular remodeling index to predict ventricular tachyarrhythmia in dilated cardiomyopathy with ejection fraction < 35.$

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Left ventricular remodeling index to predict ventricular tachyarrhythmia in dilated cardiomyopathy with ejection fraction < 35.

Objectives: To assess the left ventricular remodeling index (LVRI) for predicting ventricular tachyarrhythmia (VTA) in patients with dilated cardiomyopathy (DCM) with left ventricular ejection fraction (LVEF) < 35%.

Materials and methods: In this retrospective single-center study, consecutive DCM patients with LVEF < 35% (n = 271) who underwent cardiac magnetic resonance (CMR) imaging were followed up. The study endpoint was VTA, including sudden cardiac death and major ventricular arrhythmias. The CMR-derived LVRI was defined as the cubic root of the LV end-diastolic volume divided by the maximal LV wall thickness. Competing risk regression analysis and Kaplan-Meier analysis were used to evaluate the association of LVRI with VTA.

Results: Over 71-month median follow-up (interquartile range: 17-134 months), 35 (12.9%, mean age 46.7 years, 27 males) participants reached VTA events. The presence (62.9% vs. 60.2%, p = 0.761) and extent (6.9 ± 6.6 vs. 6.5 ± 8.3, p = 0.747) of late gadolinium enhancement (LGE) and LVEF (23.3 ± 6 vs. 21.9 ± 10.3, p = 0.197) were not significantly different between the patients with and without endpoint. Kaplan-Meier curve analysis showed that participants with LVRI ≥ 7.5 were more likely to experience VTA (p < 0.0001). In the multiple competing risk analysis, LVRI ≥ 7.5 (HR, 2.496; 95% CI: 1.213-5.138; p = 0.013) was observed as an independent predictor of VTA after adjusting for age, sex and left bundle branch block.

Conclusions: For nonischemic DCM patients with LVEF < 35%, LVRI ≥ 7.5 was associated with lethal VTA events and provided incremental value over conventional CMR parameters.

Critical relevance statement: The left ventricular remodeling index (LVRI) was independently associated with ventricular tachyarrhythmias in dilated cardiomyopathy patients with LVEF < 35%, and warrants future multicenter validation to assess incremental value over established predictors for implantable cardioverter-defibrillator decision-making.

Key points: Left ventricular ejection fraction did not exhibit significant prognostic value for end-stage dilated cardiomyopathy patients. Cardiac MRI (CMR)-assessed left ventricular remodeling index (LVRI) ≥ 7.5 was an independent predictor of ventricular tachyarrhythmia. LVRI provided incremental prognostic value over conventional CMR parameters.

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.