The relationship between extracellular volume fraction in symptomatic adults with tetralogy of Fallot and adverse cardiac events
The relationship between extracellular volume fraction in symptomatic adults with tetralogy of Fallot and adverse cardiac events
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有症状的法洛四联症成人细胞外体积分数与不良心脏事件之间的关系
DOI：
10.1016/j.jjcc.2019.09.009
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发表时间：
2020
影响因子：
2.5
通讯作者：
Inai Kei
中科院分区：
文献类型：
--
作者：
Shiina Yumi;Taniguchi Kota;Nagao Michinobu;Takahashi Tatsunori;Niwa Koichiro;Kawakubo Masateru;Inai Kei
背景：研究使用心脏磁共振（CMR） T1测得的细胞外体积分数（ECV）与成年法洛四联症（TOF）患者心脏事件之间的关系。方法前瞻性入选纽约心脏协会功能等级2-4级的连续60例有症状的完全性TOF患者（35.4±13.8岁）。采用3.0 T扫描仪和饱和恢复法进行CMR T1定位，获得右心室（RV）、左心室和室间隔自由壁的原生T1值和ECV。分析T1测图、常规参数和不良心脏事件预测因子之间的相关性。排除仅发生心房心律失常的患者。结果RV功能参数、RV- ecv和隔膜- ecv之间存在显著相关。随访时间为747.1±315天，13例患者发生心脏事件：8例患者发生急性心力衰竭和/或持续性室性心动过速，5例患者接受心脏手术。Cox-hazard analysis显示隔膜- ecv和RV-ECV是不良事件的预测因子（隔膜- ecv和RV-ECV的危险比分别为1.41和1.19,95% CI分别为1.05 ~ 1.89、1.004 ~ 1.41，p值分别为0.02和0.045）。间隔- ecv >29.0%和右心室射血分数(EF) <45.0%的成年人更容易发生心脏事件（log rank检验：p< 0.043）。结论srv - ecv和隔膜- ecv与右心室功能参数相关。双心室ECVs可以预测成人TOF患者的不良心脏事件。特别是，与使用单一CMR参数相比，隔膜- ecv和RVEF的组合是一个有用的预测因子。
BackgroundTo investigate the relationship between the extracellular volume fraction (ECV) measured using cardiac magnetic resonance (CMR) T1 mapping and cardiac events in symptomatic adults with tetralogy of Fallot (TOF).MethodsA total of 60 consecutive symptomatic adults (35.4 ± 13.8 years old) with repaired TOF who were in New York Heart Association functional class 2–4 were prospectively enrolled. Native T1 values and ECV of the free walls of the right ventricle (RV), the left ventricle, and the ventricular septum were obtained by CMR T1 mapping using a 3.0 T scanner and the saturation recovery method. Correlations between T1 mapping measurements, conventional parameters, and predictors of adverse cardiac events were analyzed. The patients with episodes of only atrial arrhythmia were excluded.ResultsSignificant correlations were observed between RV functional parameters, RV-ECV, and septum-ECV. Follow-up period was 747.1 ± 315 days and 13 patients had cardiac events: Acute heart failure and/or sustained ventricular tachycardia occurred in 8 patients and 5 patients underwent cardiac surgery. Cox-hazard analysis revealed that septum-ECV and RV-ECV were predictors of adverse events (hazard ratio of septum-ECV and RV-ECV: 1.41 and 1.19, 95% CI: 1.05–1.89, 1.004–1.41 withp-values of 0.02, and 0.045, respectively). Adults with septum-ECV >29.0% and RV ejection fraction (EF) <45.0% were more likely to experience cardiac events (log rank test:p< 0.043).ConclusionsRV-ECV and septum-ECV correlate with RV functional parameters. Biventricular ECVs can be predictors of adverse cardiac events in adults with TOF. In particular, the combination of septum-ECV and RVEF was a useful predictor, compared to the use of a single CMR parameter.