Department of Clinical Physiology, Karolinska University Hospital, and Karolinska Institutet, Stockholm, Sweden.
Nicollier-Schlegel SARL, Trélex, Switzerland.
Sci Rep. 2022 Nov 1;12(1):18364. doi: 10.1038/s41598-022-22501-9.
The electrocardiogram (ECG) and cardiovascular magnetic resonance imaging (CMR) provide powerful prognostic information. The aim was to determine their relative prognostic value. Patients (n = 783) undergoing CMR and 12-lead ECG with a QRS duration < 120 ms were included. Prognosis scores for one-year event-free survival from hospitalization for heart failure or death were derived using continuous ECG or CMR measures, and multivariable logistic regression, and compared. Patients (median [interquartile range] age 55 [43-64] years, 44% female) had 155 events during 5.7 [4.4-6.6] years. The ECG prognosis score included (1) frontal plane QRS-T angle, and (2) heart rate corrected QT duration (QTc) (log-rank 55). The CMR prognosis score included (1) global longitudinal strain, and (2) extracellular volume fraction (log-rank 85). The combination of positive scores for both ECG and CMR yielded the highest prognostic value (log-rank 105). Multivariable analysis showed an association with outcomes for both the ECG prognosis score (log-rank 8.4, hazard ratio [95% confidence interval] 1.29 [1.09-1.54]) and the CMR prognosis score (log-rank 47, hazard ratio 1.90 [1.58-2.28]). An ECG prognosis score predicted outcomes independently of CMR. Combining the results of ECG and CMR using both prognosis scores improved the overall prognostic performance.
心电图(ECG)和心血管磁共振成像(CMR)提供了强大的预后信息。目的是确定它们相对的预后价值。纳入了 783 名接受 CMR 和 12 导联心电图检查(QRS 持续时间<120ms)的患者。使用连续 ECG 或 CMR 测量值和多变量逻辑回归,推导了 1 年无因心力衰竭住院或死亡的事件无事件生存率的预后评分,并进行了比较。患者(中位数[四分位间距]年龄为 55[43-64]岁,44%为女性)在 5.7[4.4-6.6]年期间发生了 155 起事件。心电图预后评分包括(1)额面 QRS-T 角,和(2)心率校正 QT 间期(QTc)(对数秩检验 55)。CMR 预后评分包括(1)整体纵向应变,和(2)细胞外容积分数(ECV)(对数秩检验 85)。ECG 和 CMR 阳性评分的组合产生了最高的预后价值(对数秩检验 105)。多变量分析显示,心电图预后评分(对数秩检验 8.4,危险比[95%置信区间]1.29[1.09-1.54])和 CMR 预后评分(对数秩检验 47,危险比 1.90[1.58-2.28])均与结果相关。心电图预后评分独立于 CMR 预测结果。使用这两个预后评分结合 ECG 和 CMR 的结果可提高整体预后性能。