Delayed hyperenhancement magnetic resonance imaging is useful in predicting functional recovery of nonischemic left ventricular systolic dysfunction
Delayed hyperenhancement magnetic resonance imaging is useful in predicting functional recovery of nonischemic left ventricular systolic dysfunction
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DOI：
10.1016/j.cardfail.2005.10.003
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发表时间：
2006-03-01
影响因子：
6
通讯作者：
Cho, SY
中科院分区：
文献类型：
--
作者：
Park, S;Choi, BW;Cho, SY
背景：约25%的非缺血性左心室（LV）收缩功能障碍患者自发改善。然而，功能改善的预测因素尚不清楚。我们假设，心肌纤维化，评估心脏磁共振（CMR）imaging，可以预测可逆性的非缺血性LV收缩功能不全。方法和结果：CMR进行了46例。进行基线和随访超声心动图以评估LV功能的恢复。无迟发性增强的患者24例（第1组），迟发性增强的患者22例（第2组）。随访时左心室舒张末期内径（56.2 +/- 7.3 vs 62.6 +/- 11.9）、左心室收缩末期内径（43.2 +/- 9.2 vs 52.8 +/- 12.6）和左心室射血分数（LVEF）（46.8 +/- 12.4% vs 31.6 +/- 11.3%）存在显著差异。第1组中19/24例（79.2%）患者的随访超声心动图显示功能恢复，而第2组中仅2/22例（9.1%）患者显示功能恢复。延迟性高增强的缺失与敏感性、特异性、阳性预测值和阴性预测值分别为90.5%、79.2%、80.0%和90.9%，respectively.Conclusion：延迟性高增强的缺失在预测非缺血性LV收缩功能障碍的功能恢复方面表现出极好的敏感性和阴性预测值。
Background: About 25% of the patients with nonischemic left ventricular (LV) systolic dysfunction improve spontaneously. However, the predictors for functional improvement are not known. We hypothesized that myocardial fibrosis, assessed by cardiac magnetic resonance (CMR) imaging, may predict the reversibility of nonischemic LV systolic dysfunction.Methods and Results: CMR was performed in 46 patients. Baseline and follow-up echocardiography was performed to assess the recovery of LV function. There were 24 patients with absence of delayed hyperenhancement (group 1) and 22 patients with delayed hyperenhancement (group 2). There were significant difference for the follow-up LV end-diastolic dimension (56.2 +/- 7.3 versus 62.6 +/- 11.9), LV end-systolic dimension (43.2 +/- 9.2 versus 52.8 +/- 12.6), and LV ejection fraction (LVEF) (46.8 +/- 12.4% versus 31.6 +/- 11.3%). Follow-up echocardiography of 19/24 (79.2%) patients in group 1 showed functional recovery, whereas only 2/22 (9.1%) patient in group 2 showed functional recovery. The absence of delayed hyperenhancement was associated with sensitivity, specificity, positive predictive value, and negative predictive value of 90.5%, 79.2%, 80.0%, and 90.9%, respectively.Conclusion: Absence of delayed hyperenhancement demonstrated excellent sensitivity and negative predictive value in predicting functional recovery of nonischemic LV systolic dysfunction.