Left ventricular geometric remodeling in relation to non-ischemic scar pattern on cardiac magnetic resonance imaging.
Left ventricular geometric remodeling in relation to non-ischemic scar pattern on cardiac magnetic resonance imaging.
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DOI：
10.1007/s10554-014-0487-8
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发表时间：
2014-12
影响因子：
2.1
通讯作者：
Weinsaft, Jonathan W.
中科院分区：
文献类型：
--
作者：
Kim, Jiwon;Kochav, Jonathan D.;Gurevich, Sergey;Afroz, Anika;Petashnick, Maya;Volo, Samuel;Diaz, Belen;Okin, Peter M.;Horn, Evelyn;Devereux, Richard B.;Weinsaft, Jonathan W.
左心室（LV）重塑和心肌纤维化与不良心力衰竭结局有关。心脏磁共振 (CMR) 成像中壁晚期钆增强 (MW-LGE) 与非缺血性心肌病 (NICM) 密切相关，但缺血性心肌病 (ICM) 的患病率以及与心肌重构的关系尚不清楚。人群包括收缩功能障碍患者（LVEF≤40%）。 CMR 用于识别 MW-LGE，通常定义为左室间隔心肌中部或心外膜方面的纤维化。研究了 285 名患者。 MW-LGE 的发生率为 12%，NICM (32%) 的发生率是 ICM (3%，p<0.001) 的 10 倍。然而，由于 ICM 患病率较高，15% 的 MW-LGE 患者患有 ICM。尽管收缩压相似 (p=0.24)，但患有 MW-LGE 的患者与未患有 MW-LGE 的患者相比，左心室壁应力较高 (p=0.02)。在多变量分析中，MW-LGE 与 CMR 量化的 LV 舒张末期容积相关 (p=0.03)，与 LVEF 和质量无关。结合临床和影像学变量表明，在控制 NICM 的存在后，MW-LGE 与较高的 LV 舒张末期容积相关（OR=1.13 [CI 1.004-1.27] 每 10 ml/m2，p=0.04）（OR=16.0 [CI 5.8-44.1]，p<0.001）。虽然 MW-LGE 在 NICM 中更为常见，但在 ICM 中也可能发生，并且是左心室扩张的标志，与心肌病病因无关。
Left ventricular (LV) remodeling and myocardial fibrosis have been linked to adverse heart failure outcomes. Mid wall late gadolinium enhancement (MW-LGE) on cardiac magnetic resonance (CMR) imaging is well-associated with non-ischemic cardiomyopathy (NICM), but prevalence in ischemic cardiomyopathy (ICM) and association with remodeling are unknown. The population comprised patients with systolic dysfunction (LVEF≤40%). CMR was used to identify MW-LGE, conventionally defined as fibrosis of the mid-myocardial or epicardial aspect of the LV septum. 285 patients were studied. MW-LGE was present in 12%, and was 10-fold more common with NICM (32%) vs. ICM (3%, p<0.001). However, owing to higher prevalence of ICM, 15% of patients with MW-LGE had ICM. LV wall stress was higher (p=0.02) among patients with, vs. those without, MW-LGE despite similar systolic blood pressure (p=0.24). In multivariate analysis, MW-LGE was associated with CMR-quantified LV end-diastolic volume (p=0.03) independent of LVEF and mass. Incorporation of clinical and imaging variables demonstrated MW-LGE to be associated with higher LV end-diastolic volume (OR=1.13 [CI 1.004–1.27] per 10 ml/m2, p=0.04) after controlling for presence of NICM (OR=16.0 [CI 5.8–44.1], p<0.001). While more common in NICM, MW-LGE can occur in ICM and is a marker of LV chamber dilation irrespective of cardiomyopathic etiology.
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影响因子：
158.5
作者：
PFEFFER, MA;BRAUNWALD, E;HAWKINS, CM
通讯作者：
HAWKINS, CM
影响因子：
24
作者：
Assomull, Ravi G.;Prasad, Sanjay K.;Pennell, Dudley J.
通讯作者：
Pennell, Dudley J.
影响因子：
37.8
作者：
Frustaci, A;Chimenti, C;Maseri, A
通讯作者：
Maseri, A
影响因子：
4.3
作者：
Tyagi, SC;Campbell, SE;Voelker, DJ
通讯作者：
Voelker, DJ
影响因子：
4.4
作者：
Codella, Noel C. F.;Cham, Matthew D.;Weinsaft, Jonathan W.
通讯作者：
Weinsaft, Jonathan W.