Department of General Practice, The Second Affiliated Hospital of Nantong University, Shengli Road No.666, Nantong, 226001, China.
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
Sci Rep. 2024 Mar 29;14(1):7504. doi: 10.1038/s41598-024-58271-9.
Diffuse myocardial fibrosis is associated with adverse outcomes in heart failure with preserved ejection fraction (HFpEF). Dual-energy CT (DECT) can noninvasively assess myocardial fibrosis by quantification of extracellular volume (ECV) fraction. This study evaluated the association between ECV measured by DECT and clinical outcomes in patients with HFpEF. 125 hospitalized HFpEF patients were enrolled in this retrospective cohort study. ECV was measured using DECT with late iodine enhancement. The composite endpoint was defined as HFpEF hospitalization and all-cause mortality during the follow-up. During the median follow-up of 10.4 months, 34 patients (27.20%) experienced the composite outcomes, including 5 deaths; and 29 HFpEF hospitalizations. The higher DECT-ECV group had higher rates of composite outcomes than the low ECV group (log-rank X = 6.818, P = 0.033). In multivariate Cox regression analysis, the ECV (HR 1.17, 95% CI 1.06-1.30, P = 0.001) and NT-pro BNP (HR 2.83, 95% CI 1.16-6.88, P = 0.022) were independent risk factors for the adverse outcomes. Myocardial ECV measured using DECT was an independent risk factor for adverse outcomes in patients with HFpEF.
弥漫性心肌纤维化与射血分数保留的心力衰竭（HFpEF）的不良结局相关。双能量 CT（DECT）可以通过细胞外容积（ECV）分数的定量来非侵入性地评估心肌纤维化。本研究评估了 DECT 测量的 ECV 与 HFpEF 患者临床结局之间的关系。这项回顾性队列研究纳入了 125 名住院 HFpEF 患者。使用 DECT 进行晚期碘增强来测量 ECV。复合终点定义为 HFpEF 住院和随访期间的全因死亡率。在中位数为 10.4 个月的随访期间，34 名患者（27.20%）经历了复合结局，包括 5 例死亡；以及 29 例 HFpEF 住院。DECT-ECV 较高组的复合结局发生率高于 ECV 较低组（对数秩 X = 6.818，P = 0.033）。在多变量 Cox 回归分析中，ECV（HR 1.17，95%CI 1.06-1.30，P = 0.001）和 NT-proBNP（HR 2.83，95%CI 1.16-6.88，P = 0.022）是不良结局的独立危险因素。使用 DECT 测量的心肌 ECV 是 HFpEF 患者不良结局的独立危险因素。
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