通过计算机断层扫描测定细胞外容积有助于预测射血分数降低的扩张型心肌病伴心力衰竭患者的预后。
Extracellular Volume by Computed Tomography Is Useful for Prediction of Prognosis in Dilated Cardiomyopathy Cases with Heart Failure with Reduced Ejection Fraction.
作者信息
Yashima Satomi, Takaoka Hiroyuki, Ota Joji, Matsumoto Moe, Nishikawa Yusei, Noguchi Yoshitada, Aoki Shuhei, Yoshida Kazuki, Suzuki Katsuya, Kinoshita Makiko, Sasaki Haruka, Suzuki-Eguchi Noriko, Kanaeda Tomonori, Kobayashi Yoshio
机构信息
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba 260-8677, Japan.
Department of Radiology, Chiba University Hospital, Chiba 260-8677, Japan.
出版信息
J Cardiovasc Dev Dis. 2024 Dec 11;11(12):399. doi: 10.3390/jcdd11120399.
OBJECTIVE
Cardiac computed tomography (CT) helps screen coronary artery stenosis in cases with dilated cardiomyopathy (DCM). Extracellular volume fraction (ECV) analysis has recently been eligible for CT.
METHOD
We evaluated the impact of ECV on the CT to predict the prognosis in DCM patients with heart failure with reduced ejection fraction (HFrEF).
PATIENTS OR MATERIALS
We analyzed 101 consecutive DCM cases with HFrEF who underwent cardiac CT. All the patients had a lower left ventricular (LV) ejection fraction (LVEF) of less than 40%. We evaluated the effect of ECV to predict the patients' prognosis. Cardiovascular death, hospitalization due to heart failure, and fatal arrhythmic events were included in the major adverse cardiac events (MACE).
RESULTS
MACE occurred in 27 cases (27%). The patients with MACE (27 cases) had an increased ECV on the LVM on the CT (37.2 ± 6.7 vs. 32.2 ± 3.6%, = 0.0008) compared to the others (74 cases). Based on the receiver operating characteristics curve analysis, the best cutoff value of the ECV on the LVM to predict the MACE was 32.3%. The patients with ECV ≥ 32.3% had significantly higher MACE based on the Kaplan-Meier analysis. The ECV on the LVM was a significant marker to predict MACE based on the univariate Cox proportional hazard model (hazard ratio of 8.00, 95% confidence interval 1.88-33.97, = 0.0048).
CONCLUSIONS
ECV by CT is helpful to predict MACE in cases with DCM and HFrEF.
目的
心脏计算机断层扫描（CT）有助于筛查扩张型心肌病（DCM）患者的冠状动脉狭窄。细胞外容积分数（ECV）分析最近已适用于CT检查。
方法
我们评估了ECV对CT预测射血分数降低的心力衰竭（HFrEF）的DCM患者预后的影响。
患者或材料
我们分析了101例连续接受心脏CT检查的HFrEF的DCM病例。所有患者的左心室（LV）射血分数（LVEF）均低于40%。我们评估了ECV预测患者预后的效果。主要不良心脏事件（MACE）包括心血管死亡、因心力衰竭住院和致命性心律失常事件。
结果
27例（27%）发生MACE。与其他患者（74例）相比，发生MACE的患者（27例）CT上LVM的ECV增加（37.2±6.7%对32.2±3.6%，P=0.0008）。根据受试者工作特征曲线分析，LVM上ECV预测MACE的最佳截断值为32.3%。根据Kaplan-Meier分析，ECV≥32.3%的患者MACE显著更高。基于单变量Cox比例风险模型，LVM上的ECV是预测MACE的重要指标（风险比为8.00，95%置信区间为1.88-33.97，P=0.0048）。
结论
CT测量的ECV有助于预测DCM和HFrEF患者的MACE。
Zotero 插件