Marchini Federico, Dal Passo Beatrice, Campo Gianluca, Tonet Elisabetta, Serenelli Matteo, Cossu Alberto, Chiarello Serena, Lo Monaco Maria, Bertella Erika, Pavasini Rita
Cardiovascular Institute, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy.
Division of Radiology, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy.
ESC Heart Fail. 2025 Apr 25. doi: 10.1002/ehf2.15279.
The aim of this study is to investigate the prognostic role of T1 mapping techniques in predicting major adverse cardiovascular events (MACE) in patients affected by non-ischaemic dilated cardiomyopathy (NIDCM) by performing a meta-analysis of available studies.
Data from 12 observational studies exploring the prognostic role of native T1 mapping and extracellular volume (ECV) were analysed with random effect generic inverse variance. The primary endpoint was MACE defined as a composite of heart failure or arrhythmic-related events, expressed as hazard ratio (HR) with 95% confidence interval (CI). Secondary main outcomes were heart failure-related events, arrhythmic-related events, and weighted mean difference of native T1 mapping values or ECVs between patients with or without MACE. Overall, 4025 patients with NIDCM were included. The median follow-up length was 22 (IQR 14-22) months. The primary outcome of MACE occurred in 610 patients with a pooled HR for native T1 mapping values of 1.07 (95% CI 1.04-1.09, I 31.5%) and a pooled HR for ECV of 1.37 (95% CI 1.29-1.44, I 0%). HF-related events occurred in 492 patients, with a pooled HR for T1 mapping of 1.05 (95% CI 1.03-1.07, I 1%) and a pooled HR for ECVs of 1.43 (95% CI 1.25-1.61, I 63%). Arrhythmic-related events occurred in 118 patients, with a pooled HR for T1 mapping values of 1.09 (95% CI 1.07-1.12, I 0%). The weighted mean difference of native T1 mapping between patients with and without MACE was 30.91 (95% CI 18.45-43.16, I 16.72%), while the mean difference of ECV was 4.52 (95% CI 2.78-6.26, I 86%).
In NIDCM patients, native T1 mapping and ECV were associated with increased risk of the composite primary endpoint of MACE and the secondary endpoint of heart failure and arrhythmic-related events.
本研究旨在通过对现有研究进行荟萃分析，探讨T1映射技术在预测非缺血性扩张型心肌病（NIDCM）患者主要不良心血管事件（MACE）中的预后作用。
采用随机效应通用逆方差法分析了12项探索固有T1映射和细胞外容积（ECV）预后作用的观察性研究数据。主要终点为MACE，定义为心力衰竭或心律失常相关事件的复合终点，以风险比（HR）及95%置信区间（CI）表示。次要主要结局为心力衰竭相关事件、心律失常相关事件，以及有或无MACE患者之间固有T1映射值或ECV的加权平均差。总共纳入了4025例NIDCM患者。中位随访时间为22（四分位间距14 - 22）个月。610例患者发生了MACE这一主要结局，固有T1映射值的合并HR为1.07（95%CI 1.04 - 1.09，I² 31.5%），ECV的合并HR为1.37（95%CI 1.29 - 1.44，I² 0%）。492例患者发生了心力衰竭相关事件，T1映射的合并HR为1.05（95%CI 1.03 - 1.07，I² 1%），ECV的合并HR为1.43（95%CI 1.25 - 1.61，I² 63%）。118例患者发生了心律失常相关事件，固有T1映射值的合并HR为1.09（95%CI 1.07 - 1.12，I² 0%）。有或无MACE患者之间固有T1映射的加权平均差为30.91（95%CI 18.45 - 43.16，I² 16.72%），而ECV的平均差为4.52（95%CI 2.78 - 6.26，I² 86%）。
在NIDCM患者中，固有T1映射和ECV与MACE复合主要终点以及心力衰竭和心律失常相关事件次要终点的风险增加相关。
