Prognostic Significance of Delayed-Enhancement Magnetic Resonance Imaging Survival of 857 Patients With and Without Left Ventricular Dysfunction
Prognostic Significance of Delayed-Enhancement Magnetic Resonance Imaging Survival of 857 Patients With and Without Left Ventricular Dysfunction
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DOI：
10.1161/circulationaha.109.852517
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发表时间：
2009-11-24
期刊：
影响因子：
37.8
通讯作者：
Flamm, Scott D.
中科院分区：
文献类型：
--
作者：
Cheong, Benjamin Y. C.;Muthupillai, Raja;Flamm, Scott D.
背景-左心室射血分数是心脏病患者（尤其是患有冠状动脉疾病的患者）生存的强大独立预测因子。延迟增强磁共振成像（DE-MRI）可以以高空间分辨率和对比度分辨率准确识别不可逆的心肌损伤。迄今为止，关于 DE-MRI 预后价值的数据相对有限，因此我们试图确定 DE-MRI 结果是否独立预测生存。方法和结果 - 对在三级护理中心进行完整电影和 DE-MRI 评估的 857 名连续患者的病历进行审查，无论患者是否患有冠状动脉疾病。心肌疤痕的存在和程度由一位经验丰富的观察者进行定性评估。主要复合终点是全因死亡率或心脏移植。生存数据来自社会保障死亡指数。中位随访时间为 4.4 年； 252 名患者 (29%) 达到了其中一项终点。死亡率或移植的独立预测因素包括充血性心力衰竭、射血分数和年龄（P
Background-Left ventricular ejection fraction is a powerful independent predictor of survival in cardiac patients, especially those with coronary artery disease. Delayed-enhancement magnetic resonance imaging (DE-MRI) can accurately identify irreversible myocardial injury with high spatial and contrast resolution. To date, relatively limited data are available on the prognostic value of DE-MRI, so we sought to determine whether DE-MRI findings independently predict survival.Methods and Results-The medical records of 857 consecutive patients who had complete cine and DE-MRI evaluation at a tertiary care center were reviewed regardless of whether the patients had coronary artery disease. The presence and extent of myocardial scar were evaluated qualitatively by a single experienced observer. The primary, composite end point was all-cause mortality or cardiac transplantation. Survival data were obtained from the Social Security Death Index. The median follow-up was 4.4 years; 252 patients (29%) reached one of the end points. Independent predictors of mortality or transplantation included congestive heart failure, ejection fraction, and age (P