Early Diastolic Longitudinal Strain Rate at MRI and Outcomes in Heart Failure with Preserved Ejection Fraction
Early Diastolic Longitudinal Strain Rate at MRI and Outcomes in Heart Failure with Preserved Ejection Fraction
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MRI 舒张早期纵向应变率和射血分数保留的心力衰竭的结果
DOI：
10.1148/radiol.2021210188
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发表时间：
2021-12-01
期刊：
影响因子：
19.7
通讯作者：
Lu, Minjie
中科院分区：
文献类型：
--
作者：
He, Jian;Yang, Wenjing;Lu, Minjie
工作背景：通过使用特征跟踪评估亚临床心肌功能不全已显示出在射血分数保留的心力衰竭（HFpEF）预后评估中的前景。整体舒张早期纵向应变率（eGLSR）可以识别早期舒张功能障碍;然而，其在HFpEF中的预后价值的数据有限。目的：评价左心室（LV）eGLSR与主要复合结局之间的关系（全因死亡或心力衰竭住院）。材料和方法：在这项回顾性研究中，连续HFpEF患者（包括2010年1月至2013年3月）接受了心血管MRI。使用线性回归评估eGLSR与变量之间的相关性。通过使用考克斯比例回归分析eGLSR（使用特征跟踪获得）和结果之间的关联。结果：共纳入186例HFpEF患者（平均年龄+/-标准差，59岁+/- 12岁; 77名女性）。eGLSR与左室舒张末期容积指数（Pearson相关系数[r] = 0.35; P <0.001）、心率（r = 0.35; P <0.001）和左室射血分数（r = 0.30; P <0.001）弱相关，与左室收缩末期容积指数中度相关（r = 0.41; P <0.001）。中位随访时间为9.2年（四分位距，8.7-10.0年），72名患者经历了主要复合结局。受损的eGLSR（定义为eGLSR小于0.57/秒）与心力衰竭住院率或全因死亡率较高相关（风险比，2.0 [95%CI：1.1，3.7]; P = 0.02）调整多个基于临床影像学的变量后。心血管MRI特征跟踪获得的左心室整体舒张早期纵向应变率与射血功能保留的心力衰竭患者的不良结局独立相关分数(C)RSNA，2021年
Background: Assessment of subclinical myocardial dysfunction by using feature tracking has shown promise in prognosis evaluation of heart failure with preserved ejection fraction (HFpEF). Global early diastolic longitudinal strain rate (eGLSR) can identify earlier diastolic dysfunction; however, limited data are available on its prognostic value in HFpEF.Purpose: To evaluate the association between left ventricular (LV) eGLSR and primary composite outcomes (all-cause death or heart failure hospitalization) in patients with HFpEF.Materials and Methods: In this retrospective study, consecutive patients with HFpEF (included from January 2010 to March 2013)underwent cardiovascular MRI. The correlation between eGLSR and variables was assessed by using linear regression. The association between eGLSR (obtained with use of feature tracking) and outcomes was analyzed by using Cox proportional regression.Results: A total of 186 patients with HFpEF (mean age +/- standard deviation, 59 years +/- 12; 77 women) were included. The eGLSR was weakly correlated with LV end-diastole volume index (Pearson correlation coefficient [r] =.0.35; P < .001), heart rate(r = 0.35; P < .001), and LV ejection fraction (r = 0.30; P < .001) and moderately correlated with LV end-systole volume index(r =.0.41; P < .001). At a median follow-up of 9.2 years (interquartile range, 8.7-10.0 years), 72 patients experienced primary composite outcomes. Impaired eGLSR, defined as an eGLSR of less than 0.57 per second, was associated with a greater rate of heart failure hospitalization or all-cause death (hazard ratio, 2.0 [95% CI: 1.1, 3.7]; P =.02) after adjusting for multiple clinical andimaging-based variables.Conclusion: Left ventricular global early diastolic longitudinal strain rate obtained from cardiovascular MRI feature tracking was independently associated with adverse outcomes in patients with heart failure with preserved ejection fraction. (C) RSNA, 2021