Liu Tong, Gao Yifeng, Wang Hui, Zhou Zhen, Wang Rui, Chang San-Shuai, Liu Yuanyuan, Sun Yuqing, Rui Hongliang, Yang Guang, Firmin David, Dong Jianzeng, Xu Lei
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Heart. 2021 Jul 12;107(15):1233-1239. doi: 10.1136/heartjnl-2020-317949.
To explore the association between three-dimensional (3D) cardiac magnetic resonance (CMR) feature tracking (FT) right ventricular peak global longitudinal strain (RVpGLS) and major adverse cardiovascular events (MACEs) in patients with stage C or D heart failure (HF) with non-ischaemic dilated cardiomyopathy (NIDCM) but without atrial fibrillation (AF).
Patients with dilated cardiomyopathy were enrolled in this prospective cohort study. Comprehensive clinical and biochemical analysis and CMR imaging were performed. All patients were followed up for MACEs.
A total of 192 patients (age 53±14 years) were eligible for this study. A combination of cardiovascular death and cardiac transplantation occurred in 18 subjects during the median follow-up of 567 (311, 920) days. Brain natriuretic peptide, creatinine, left ventricular (LV) end-diastolic volume, LV end-systolic volume, right ventricular (RV) end-diastolic volume and RVpGLS from CMR were associated with the outcomes. The multivariate Cox regression model adjusting for traditional risk factors and CMR variables detected a significant association between RVpGLS and MACEs in patients with stage C or D HF with NIDCM without AF. Kaplan-Meier analysis based on RVpGLS cut-off value revealed that patients with RVpGLS <-8.5% showed more favourable clinical outcomes than those with RVpGLS ≥-8.5% (p=0.0037). Subanalysis found that this association remained unchanged.
RVpGLS-derived from 3D CMR FT is associated with a significant prognostic impact in patients with NIDCM with stage C or D HF and without AF.
探讨三维（3D）心脏磁共振（CMR）特征追踪（FT）右心室峰值整体纵向应变（RVpGLS）与C期或D期非缺血性扩张型心肌病（NIDCM）伴心力衰竭（HF）且无房颤（AF）患者的主要不良心血管事件（MACE）之间的关联。
扩张型心肌病患者纳入本前瞻性队列研究。进行了全面的临床和生化分析以及CMR成像。所有患者均随访MACE。
共有192例患者（年龄53±14岁）符合本研究条件。在567（311，920）天的中位随访期内，18例患者发生了心血管死亡和心脏移植的联合事件。CMR检测的脑钠肽、肌酐、左心室（LV）舒张末期容积、LV收缩末期容积、右心室（RV）舒张末期容积和RVpGLS与预后相关。在调整了传统危险因素和CMR变量的多变量Cox回归模型中，检测到C期或D期NIDCM无AF的HF患者中，RVpGLS与MACE之间存在显著关联。基于RVpGLS临界值的Kaplan-Meier分析显示，RVpGLS<-8.5%的患者比RVpGLS≥-8.5%的患者临床结局更优（p=0.0037）。亚分析发现这种关联保持不变。
3D CMR FT得出的RVpGLS与C期或D期NIDCM且无AF的HF患者的预后有显著关联。
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