Aoki Shuhei, Takaoka Hiroyuki, Kanaeda Tomonori, Asada Kazunari, Ota Joji, Noguchi Yoshitada, Matsumoto Moe, Nishikawa Yusei, Suzuki Katsuya, Yashima Satomi, Kinoshita Makiko, Suzuki-Eguchi Noriko, Sasaki Haruka, Takahashi Kohei, Ozawa Yoshihito, Inaba Yosuke, Kobayashi Yoshio
Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8677, Japan.
Department of Cardiovascular Medicine, Eastern Chiba Medical Center, Togane 283-8686, Japan.
J Cardiovasc Dev Dis. 2025 Sep 19;12(9):372. doi: 10.3390/jcdd12090372.
Extracellular volume fraction (ECV) analysis on computed tomography (CT) is now available. The purpose of this study was to assess the usefulness of CT-derived ECV analysis for predicting outcomes in patients with hypertrophic cardiomyopathy (HCM). One hundred and one HCM patients (67 males, 66 ± 11 years old) who received cardiac CT between January 2009 and December 2021 were included. We measured left ventricular (LV) ECV (LV-ECV) on CT and investigated the relationship between LV-ECV and the major adverse cardiac events (MACE) after CT. Fifteen patients (15%) experienced MACE. The patients with MACE had a significantly higher LV-ECV, left atrial diameter, LV end-systolic diameter, and lower LVEF than those without MACE. The proportion of dilated phase HCM was significantly higher in the patients with MACE than those without MACE. LV-ECV and LVEF were significant predictors of MACE based on the multivariate analysis by Cox proportional hazards model. The optimal threshold of LV-ECV to predict MACE was 37.6% based on the receiver operating characteristic analysis. The patients with LV-ECV ≥ 37.6% (30 patients) experienced significantly higher MACE than those with LV-ECV < 37.6% ( < 0.001). CT-derived ECV analysis suggested potential usefulness for predicting MACE in patients with HCM.
目前，计算机断层扫描（CT）上的细胞外容积分数（ECV）分析已经可用。本研究的目的是评估CT衍生的ECV分析对预测肥厚型心肌病（HCM）患者预后的有用性。纳入了2009年1月至2021年12月期间接受心脏CT检查的101例HCM患者（67例男性，年龄66±11岁）。我们在CT上测量了左心室（LV）的ECV（LV-ECV），并研究了LV-ECV与CT检查后主要不良心脏事件（MACE）之间的关系。15例患者（15%）发生了MACE。发生MACE的患者的LV-ECV、左心房直径、LV收缩末期直径显著高于未发生MACE的患者，而左心室射血分数（LVEF）则较低。发生MACE的患者中HCM扩张期的比例显著高于未发生MACE的患者。基于Cox比例风险模型的多变量分析，LV-ECV和LVEF是MACE的显著预测因素。根据受试者工作特征分析，预测MACE的LV-ECV最佳阈值为37.6%。LV-ECV≥37.6%的患者（30例）发生MACE的比例显著高于LV-ECV<37.6%的患者（P<0.001）。CT衍生的ECV分析显示对预测HCM患者的MACE具有潜在的有用性。
