Myocardial fibrosis detected by cardiac CT predicts ventricular fibrillation/ventricular tachycardia events in patients with hypertrophic cardiomyopathy.
Myocardial fibrosis detected by cardiac CT predicts ventricular fibrillation/ventricular tachycardia events in patients with hypertrophic cardiomyopathy.
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DOI：
10.1016/j.jcct.2013.04.002
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发表时间：
2013-05
影响因子：
5.4
通讯作者：
Rochitte CE
中科院分区：
文献类型：
--
作者：
Shiozaki AA;Senra T;Arteaga E;Martinelli Filho M;Pita CG;Ávila LF;Parga Filho JR;Mady C;Kalil-Filho R;Bluemke DA;Rochitte CE
高达 80% 的无症状或轻度症状肥厚型心肌病 (HCM) 受试者会出现心肌纤维化 (MF)，并且可能成为易感人群发生折返性、危及生命的室性心律失常的致心律失常基础。目的是调查延迟增强心脏 CT 检测到的 MF 是否可以预测 HCM 患者出现室性心动过速 (VT) 和颤动 (VF)，而这些情况需要植入式心脏复律除颤器 (ICD) 进行适当治疗。 26 名先前（至少 1 年）植入 ICD 的 HCM 患者接受了心脏 CT 的 MF 评估。 MF 通过心肌延迟增强心脏 CT 进行量化。 ICD 植入后每 3 个月记录一次 ICD 放电数据。对所有 HCM 患者心源性猝死的危险因素进行了评估。 26 名患者中有 25 名 (96%) 存在 MF，平均纤维化质量为 20.5 ± 15.8 g。针对 VF/VT 进行适当 ICD 电击的患者的 MF 质量显着大于未进行 VF/VT 电击的患者（29.10 ± 19.13 g vs 13.57 ± 8.31 g；P = .01）。对于至少 18 g 的 MF 质量，适当 ICD 触发的敏感性和特异性分别为 73%（95% CI，49%–88%）和 71%（95% CI，56%–81%）。 Kaplan-Meier 曲线表明，MF 质量≥18 g 的患者的 VF/VT 事件发生率显着高于 MF <18 g 的患者 (P = .02)。在 Cox 回归分析中，MF 量与 ICD 存储的电描记图中的 VF/VT 独立相关。猝死高危 HCM 患者通过心脏 CT 检测到的 MF 质量与适当的 ICD 触发相关。
Myocardial fibrosis (MF) occurs in up to 80% of subjects with asymptomatic or mildly symptomatic hypertrophic cardiomyopathy (HCM) and can constitute an arrhythmogenic substrate for re-entrant, life-threatening ventricular arrhythmias in predisposed persons. The aim was to investigate whether MF detected by delayed enhancement cardiac CT is predictive of ventricular tachycardia (VT) and fibrillation (VF) that require appropriate therapy by an implantable cardioverter defibrillator (ICD) in patients with HCM. Twenty-six patients with HCM with previously (for at least 1 year) implanted ICD underwent MF evaluation by cardiac CT. MF was quantified by myocardial delayed enhanced cardiac CT. Data on ICD firing were recorded every 3 months after ICD implantation. Risk factors for sudden cardiac death in patients with HCM were evaluated in all patients. MF was present in 25 of 26 patients (96%) with mean fibrosis mass of 20.5 ± 15.8 g. Patients with appropriate ICD shocks for VF/VT had significantly greater MF mass than patients without (29.10 ± 19.13 g vs 13.57 ± 8.31 g; P = .01). For a MF mass of at least 18 g, sensitivity and specificity for appropriate ICD firing were 73% (95% CI, 49%–88%) and 71% (95% CI, 56%–81%), respectively. Kaplan–Meier curves indicated a significantly greater VF/ VT event rate in patients with MF mass ≥18 g than in patients with MF <18 g (P = .02). In the Cox regression analysis, the amount of MF was independently associated with VF/VT in ICD-stored electrograms. The mass of MF detected by cardiac CT in patients with HCM at high risk of sudden death was associated with appropriate ICD firings.
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DOI：
10.1186/1532-429x-15-12
发表时间：
2013-01-19
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
Alexandre J;Saloux E;Dugué AE;Lebon A;Lemaitre A;Roule V;Labombarda F;Provost N;Gomes S;Scanu P;Milliez P
通讯作者：
Milliez P
影响因子：
37.8
作者：
Lardo, AC;Cordeiro, MAS;Lima, JAC
通讯作者：
Lima, JAC
影响因子：
158.5
作者：
Maron, BJ;Shen, WK;Spirito, P
通讯作者：
Spirito, P
DOI：
10.1016/0735-1097(89)90302-1
发表时间：
1989-05-01
影响因子：
24
作者：
CECCHI, F;MARON, BJ;EPSTEIN, SE
通讯作者：
EPSTEIN, SE
DOI：
10.1016/s0735-1097(01)01386-9
发表时间：
2001-08-01
影响因子：
24
作者：
Maron, BJ;Niimura, H;Seidman, CE
通讯作者：
Seidman, CE