Global strain and dyssynchrony of the single ventricle predict adverse cardiac events after the Fontan procedure: Analysis using feature-tracking cine magnetic resonance imaging
Global strain and dyssynchrony of the single ventricle predict adverse cardiac events after the Fontan procedure: Analysis using feature-tracking cine magnetic resonance imaging
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DOI：
10.1016/j.jjcc.2018.07.005
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发表时间：
2019-01-01
影响因子：
2.5
通讯作者：
Sakai, Shuji
中科院分区：
文献类型：
--
作者：
Ishizaki, Umiko;Nagao, Michinobu;Sakai, Shuji
背景资料：本研究的目的是确定Fontan手术后期的主要不良心脏事件（MACE）是否可以通过使用心脏磁共振成像与特征跟踪（CMR-FT）的单心室应变测量来预测。100例接受Fontan手术的青少年患者（平均年龄21岁）进行回顾性CMR-FT检查，以评估系统性单心室功能。垂直长轴电影成像分为6个心肌节段。通过平均六个节段中每个节段的峰值应变值来确定整体纵向应变（GLS）。不同步指数定义为6个节段达到峰值应变时间的标准差。主要结局为MACE，定义为心源性死亡和计划外住院。结果：平均随访62个月，18例患者发生MACE。根据潜在预测变量的多因素Logistic回归分析结果，GLS和不同步指数是MACE的独立预测因素。GLS ≥ 11.8%的患者的无MACE率显著高于GLS患者
Background: The aim of this study was to determine whether major adverse cardiac events (MACE) during the late phase of the Fontan procedure could be predicted by strain measurements of single ventricles using cardiac magnetic resonance imaging with feature tracking (CMR-FT).Methods: One hundred adolescent patients who underwent the Fontan procedure (mean age, 21 years) were examined retrospectively with CMR-FT to assess the systemic single-ventricle function. Vertical long-axis cine imaging was divided into six myocardial segments. Global longitudinal strain (GLS) was determined by averaging the peak strain values of each of the six segments. The dyssynchrony index was defined as the standard deviation of the time to peak strain for six segments. The primary outcome was MACE, defined as cardiac death and unscheduled hospitalization.Results: MACE occurred in 18 patients during a mean follow-up of 62 months. According to the multivariate logistic regression analysis results for potential predictor variables, GLS and the dyssynchrony index are independent predictors of MACE. Patients with GLS >= 11.8% had significantly higher MACE-free rates than did those with GLS