The Effect of Cardiac Fibrosis on Left Ventricular Remodeling, Diastolic Function, and N-Terminal Pro-B-Type Natriuretic Peptide Levels in Patients with Nonischemic Dilated Cardiomyopathy
The Effect of Cardiac Fibrosis on Left Ventricular Remodeling, Diastolic Function, and N-Terminal Pro-B-Type Natriuretic Peptide Levels in Patients with Nonischemic Dilated Cardiomyopathy
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DOI：
10.1111/j.1540-8175.2010.01170.x
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发表时间：
2010-09-01
影响因子：
1.5
通讯作者：
Basaran, Yelda
中科院分区：
文献类型：
--
作者：
Karaahmet, Tansu.;Tigen, Kursat.;Basaran, Yelda
背景：心脏纤维化在心力衰竭患者中很常见，且与预后不良相关。我们研究了心脏纤维化对非缺血性扩张型心肌病（NIDC）患者左心室（LV）舒张功能、功能容量、LV重构和生化参数的影响。此外，我们研究了该组中心脏纤维化的生化和超声心动图预测因子。方法和结果：40例NIDC患者入组。根据心脏磁共振（CMR）成像上晚期钆增强（LGE）的存在来评估心脏纤维化。19例患者有心脏纤维化（组I），21例患者没有心脏纤维化（组II）。用常规和组织多普勒超声心动图评估左室收缩和舒张参数。记录每例患者的N末端B型利钠肽前体（NT-pro BNP）水平。心脏纤维化患者舒张功能受损，心功能分级和NT-pro BNP水平高于无心脏纤维化患者，左室重构明显。相关性分析显示，心脏纤维化程度与心功能分级、心腔大小、NT-pro BNP水平、舒张功能参数如E/Se相关。线性回归分析显示NT-pro BNP和E/Se是心肌纤维化的独立预测因子。结论：心脏纤维化与NIDC患者的LV舒张功能和功能容量受损、NT-proBNP水平升高和不良心脏重塑相关。因此，评估心脏纤维化可能有助于这些患者的管理。（超声心动图2010;27：954-960）。
Background: Cardiac fibrosis is common and associated with poor prognosis in patients with heart failure. We investigated the effect of cardiac fibrosis on the left ventricular (LV) diastolic function, functional capacity, LV remodeling, and biochemical parameters in patients with nonischemic dilated cardiomyopathy (NIDC). In addition, we investigated the biochemical and echocardiographic predictors of cardiac fibrosis in this group. Methods and Results: Forty patients with NIDC were enrolled. Cardiac fibrosis was evaluated according to the presence of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging. Nineteen patients had cardiac fibrosis (Group I) and 21 patients did not have cardiac fibrosis (Group II). LV systolic and diastolic parameters were assessed with conventional and tissue Doppler echocardiography. N-terminal pro-B-type natriuretic peptide (NT-pro BNP) levels of each patient were recorded. Patients with cardiac fibrosis had impaired diastolic function, higher functional class and NT-pro BNP levels, and significant LV remodeling than the patients without cardiac fibrosis. A correlation analysis revealed that the cardiac fibrosis severity was associated with functional class, cardiac chamber sizes, NT-pro BNP levels, diastolic parameters such as E/Se. A linear regression analysis demonstrated that NT-pro BNP and E/Se were the independent predictors of cardiac fibrosis. Conclusion: Cardiac fibrosis correlates with impaired LV diastolic function and functional capacity, elevated NT-proBNP levels, and adverse cardiac remodeling in patients with NIDC. Therefore, the assessment of cardiac fibrosis can be useful in the management of these patients. (Echocardiography 2010;27:954-960).