Suppr超能文献

新型 Z 评分可纠正因心室容量指数与体表面积关联而导致的青少年和青年人群中的偏倚。

Novel Z Scores to Correct Biases Due to Ventricular Volume Indexing to Body Surface Area in Adolescents and Young Adults.

机构信息

Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, Québec, Canada.

Université de Montréal, Montréal, Québec, Canada.

出版信息

Can J Cardiol. 2021 Mar;37(3):417-424. doi: 10.1016/j.cjca.2020.06.009. Epub 2020 Jun 22.

Abstract

BACKGROUND

Reference values for cardiac magnetic resonance imaging (cMRI) in children and young adults are scarce. This leads to risk stratification of patients with congenital heart diseases being based on volumes indexed to body surface area (BSA). We aimed to produce cMRI Z score equations for ventricular volumes in children and young adults and to test whether indexing to BSA resulted in an incorrect assessment of ventricular dilation according to sex, body composition, and growth.

METHODS

We retrospectively included 372 subjects aged < 26 years with either normal hearts or conditions with no impact on ventricular volumes (reference group), and 205 subjects with repaired tetralogy of Fallot (TOF) aged < 26 years. We generated Z score equations by means of multivariable regression modelling. Right ventricular dilation was assessed with the use of Z scores and compared with indexing to BSA in TOF subjects.

RESULTS

Ventricular volume Z scores were independent from age, sex, and anthropometric measurements, although volumes indexed to BSA showed significant residual association with sex and body size. In TOF subjects, indexing overestimated dilation in growing children and underestimated dilation in female compared with male subjects, and in overweight compared with lean subjects.

CONCLUSIONS

Indexed ventricular volumes measured with cMRI did not completely adjust for body size and resulted in a differential error in the assessment of ventricular dilation according to sex and body size. Our proposed Z score equations solved this problem. Future studies should evaluate if ventricular volumes expressed as Z scores have a better prognostic value than volumes indexed to BSA.

摘要

背景

儿童和年轻成年人心脏磁共振成像(cMRI)的参考值很少。这导致先天性心脏病患者的风险分层基于体表面积(BSA)指数化的容积。我们旨在为儿童和年轻成年人的心室容积生成 cMRI Z 分数方程,并测试根据性别、身体成分和生长指数化到 BSA 是否会导致心室扩张的不正确评估。

方法

我们回顾性纳入了 372 名年龄<26 岁的具有正常心脏或对心室容积无影响的疾病的患者(参考组),以及 205 名年龄<26 岁的修复性法洛四联症(TOF)患者。我们通过多变量回归模型生成 Z 分数方程。使用 Z 分数评估右心室扩张,并在 TOF 患者中与 BSA 指数化进行比较。

结果

心室容积 Z 分数与年龄、性别和人体测量学测量无关,尽管 BSA 指数化的容积与性别和体型仍有显著的残留关联。在 TOF 患者中,与男性相比,指数化高估了生长中的儿童的扩张,低估了女性的扩张,与瘦相比,指数化高估了超重的扩张。

结论

cMRI 测量的指数化心室容积不能完全调整体型,并且根据性别和体型的不同,在评估心室扩张方面会产生差异误差。我们提出的 Z 分数方程解决了这个问题。未来的研究应评估以 Z 分数表示的心室容积是否比 BSA 指数化的容积具有更好的预后价值。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验