1.Prediction of adverse cardiac events in dilated cardiomyopathy using cardiac T2* MRI and MIBG scintigraphy.
1.Prediction of adverse cardiac events in dilated cardiomyopathy using cardiac T2* MRI and MIBG scintigraphy.
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1. 使用心脏 T2* MRI 和 MIBG 闪烁扫描预测扩张型心肌病的不良心脏事件。
DOI：
10.1007/s10554-014-0562-1
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发表时间：
2015
影响因子：
2.1
通讯作者：
Hiroshi Honda
中科院分区：
文献类型：
--
作者：
Michinobu Nagao;Shingo Baba;Masato Yonezawa;Yuzo Yamasaki;Takeshi Kamitani;Takuro Isoda;Satoshi Kawanami;Yasuhiro Maruoka;Yoshiyuki Kitamura;Kohtaro Abe;Taiki Higo;Kenji Sunagawa;Hiroshi Honda
缺铁和心脏交感神经损伤在心力衰竭的恶化中起作用，这两种情况可能是相关的。本研究旨在阐明扩张型心肌病（DCM）患者心肌缺铁、心脏交感神经活性和主要不良心脏事件（MACE）之间的关系。对46例扩张型心肌病患者进行了心脏T2 ~* MRI铁缺乏和123 I-间碘苄胍（MIBG）心脏交感神经活动显像。用3 T扫描仪将左室中间隔的信号强度数据拟合成衰减曲线，计算心肌T2* 值（M-T2*），用极图技术计算123 I-MIBG洗脱率（MIBG-WR）。分析M-T2* 和MIBG-WR预测MACE的能力。发生MACE的DCM患者的MIBG-WR和M-T2* 显著高于未发生MACE的患者。受试者操作特征曲线分析显示，最佳MIBG-WR和M-T2* 阈值分别为35%和28.1 ms，两种组合预测MACE的C-静态分别为0.69、0.73和0.82。MIBG-WR <35%和M-T2* <28.1 ms的患者无事件发生率显著低于MIBG-WR ≥ 35%或M-T2* ≥28.1 ms的患者（log-rank值= 4.35，p < 0.05）。考克斯风险回归分析显示，MIBG-WR ≥ 35%或M-T2* ≥28.1 ms的患者发生MACE的χ 2和风险比分别为3.99和2.15（p< 0.05）。在DCM患者中，由高M-T2* 表达的铁缺乏和MIBG-WR都是MACE的独立预测因子。这两个参数的组合是一个更强大的预测MACE比任何参数单独。
Iron deficiency and cardiac sympathetic impairment play a role in the worsening of heart failure, and these two conditions may be linked. The present study aimed to clarify the relationship between myocardial iron deficiency, cardiac sympathetic activity, and major adverse cardiac events (MACE) in patients with dilated cardiomyopathy (DCM). Cardiac T2* MRI for iron deficiency and123I-Metaiodobenzylguanidine (MIBG) imaging for cardiac sympathetic activity were performed in 46 patients with DCM. Myocardial T2* value (M-T2*) was calculated by fitting signal intensity data for mid-left ventricular septum to a decay curve using 3-Tesla scanner.123I-MIBG washout rate (MIBG-WR) was calculated using a polar-map technique with tomographic data. We analyze the ability of M-T2* and MIBG-WR to predict MACE. MIBG-WR and M-T2* were significantly greater in DCM patients with MACE than in patients without MACE. Receiver-operating-characteristics curve analysis showed that the optimal MIBG-WR and M-T2* thresholds of 35 % and 28.1 ms, and the two combination predict MACE with C-statics of 0.69, 0.73, and 0.82, respectively. Patients with MIBG-WR <35 % and M-T2* <28.1 ms had significantly lower event-free rates than those with MIBG-WR ≥35 % or M-T2* ≥28.1 ms (log-rank value = 4.35,p< 0.05). Cox hazard regression analysis showed that χ2and the hazard ratio were 3.99 and 2.15 for development of MACE in patients with MIBG-WR ≥35 % or M-T2* ≥28.1 ms (p< 0.05). Iron deficiency, expressed by a high M-T2*, and MIBG-WR were both independent predictors of MACE in patients with DCM. The two combination was a more powerful predictor of MACE than either parameter alone.