Golukhova Elena, Bulaeva Naida, Alexandrova Svetlana, Gromova Olga, Berdibekov Bektur
Bakulev Scientific Center for Cardiovascular Surgery, 121552 Moscow, Russia.
J Clin Med. 2022 Apr 30;11(9):2531. doi: 10.3390/jcm11092531.
Objectives: Our study aimed at conducting a systematic review and meta-analysis, with the objective of evaluating the prognostic value of T1 mapping techniques via cardiac magnetic resonance (CMR) in heart failure with preserved ejection fraction (HFpEF) patients. Materials and methods: The protocol was prospectively registered in the international prospective register of systematic reviews PROSPERO (registration number CRD42022300991). We searched PubMed, Google Scholar, and EMBASE for studies examining the prognostic value of characterizing myocardial tissue via CMR imaging with T1 mapping in HFpEF. Hazard ratios (HRs) for uniformly defined predictors were pooled for meta-analysis. Results: In total, 7 studies were retrieved from 351 publications for this systematic review and meta-analysis. A total of 1930 patients (mean age of 69.4 years, mean follow-up duration of 25.6 months) was included in the analysis. The meta-analysis demonstrated that higher extracellular volume (ECV) was associated with an increased risk of death and/or hospitalization with heart failure (HF) (HR:1.12; 95% CI: 1.06−1.18; p < 0.0001). After adjusting for baseline characteristics, the higher extent of ECV remained strongly associated with the risk of death and/or hospitalization with HF (HRadjusted: 1.08; 95% CI: 1.04−1.13; p = 0.0001). However, no significant association of native T1 value with risk of death or adverse cardiovascular events was found (HR:1.01; 95% CI: 1.00−1.02; p = 0.21). Conclusion: Assessment of ECV via CMR has an important prognostic value for outcomes of death and/or hospitalization with HF, and can therefore be used as an effective tool for risk stratification of patients with HFpEF.
我们的研究旨在进行一项系统评价和荟萃分析，目的是评估通过心脏磁共振成像（CMR）的T1映射技术对射血分数保留的心力衰竭（HFpEF）患者的预后价值。材料与方法：该方案已在国际前瞻性系统评价注册库PROSPERO中进行前瞻性注册（注册号CRD42022300991）。我们在PubMed、谷歌学术和EMBASE中检索了关于通过CMR成像的T1映射来表征心肌组织在HFpEF中的预后价值的研究。对统一定义的预测因子的风险比（HR）进行汇总以进行荟萃分析。结果：在本次系统评价和荟萃分析中，从351篇出版物中总共检索到7项研究。分析共纳入1930例患者（平均年龄69.4岁，平均随访时间25.6个月）。荟萃分析表明，较高的细胞外容积（ECV）与死亡和/或因心力衰竭（HF）住院风险增加相关（HR：1.12；95%置信区间：1.06−1.18；p<0.0001）。在对基线特征进行调整后，较高程度的ECV仍与因HF死亡和/或住院风险密切相关（调整后HR：1.08；95%置信区间：1.04−1.13；p = 0.0001）。然而，未发现固有T1值与死亡风险或不良心血管事件之间存在显著关联（HR：1.01；95%置信区间：1.00−1.02；p = 0.21）。结论：通过CMR评估ECV对HF死亡和/或住院结局具有重要的预后价值，因此可作为HFpEF患者风险分层的有效工具。
