The prognostic value of 2D strain in assessment of the right ventricle in patients with dilated cardiomyopathy
The prognostic value of 2D strain in assessment of the right ventricle in patients with dilated cardiomyopathy
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DOI：
10.1093/ehjci/jez015
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发表时间：
2019-09-01
影响因子：
6.2
通讯作者：
Rhee, Kun Joo
中科院分区：
文献类型：
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作者：
Seo, Jongkwon;Jung, In Hyun;Rhee, Kun Joo
目的：已有几项研究报告使用右心室（RV）应变作为评价各种心血管疾病患者RV功能的方法;然而，RV应变在扩张型心肌病（DCM）窦性心律患者中的临床相关性尚不清楚。本研究的目的是调查右心室应变和不良事件之间的关系，在DCM患者窦性rhythm.Methods和结果我们招募了143名DCM患者窦性心律谁已经首次诊断，评估，并在2013年3月和2017年8月之间在Sanggye Paik医院随访。我们进行了超声心动图和测量RV应变值使用心尖四腔视图。平均年龄为64.6岁。在中位40.0个月的随访期内，21例患者（14.7%）发生了不良心血管事件。通过考克斯比例风险多变量分析，只有右心室游离壁纵向应变（RV-FWLS）独立预测主要结局。受试者工作特征曲线分析显示，识别发生事件患者的最佳RV-FWLS截止值为-16.5%（曲线下面积= 0.703，P = 0.003）。根据RV-FWLS为-16.5%分为两组，RV-FWLS为-16.5%（log-rank检验，P < 0.001）。
Aims Several studies have been reported using right ventricular (RV) strain as a method for evaluating RV function in patients with various cardiovascular diseases; however, the clinical relevance of RV strain in dilated cardiomyopathy (DCM) patients with sinus rhythm is unknown. The aim of this study was to investigate the relationship between RV strain and adverse events in DCM patients with sinus rhythm.Methods and results We enrolled 143 DCM patients with sinus rhythm who had been first diagnosed, evaluated, and followed at Sanggye Paik Hospital between March 2013 and August 2017. We performed echocardiography and measured RV strain values using the apical four-chamber view. The mean age was 64.6 years. During the median follow-up period of 40.0 months, adverse cardiovascular events developed in 21 patients (14.7%). By Cox proportional hazards multivariate analysis, only RV free wall longitudinal strain (RV-FWLS) independently predicted the primary outcome. Receiver-operating characteristic curve analysis showed that the optimal RV-FWLS cut-off value to identify patients with an event was -16.5% (area under the curve = 0.703, P = 0.003). When we divided the subjects into two groups based on the RV-FWLS of -16.5%, patients with RV-FWLS =-16.5% (log-rank test, P < 0.001).Conclusion RV-FWLS was associated with a significant prognostic impact in DCM patients with sinus rhythm.