Cardiovascular Magnetic Resonance to Predict Appropriate Implantable Cardioverter Defibrillator Therapy in Ischemic and Nonischemic Cardiomyopathy Patients Using Late Gadolinium Enhancement Border Zone Comparison of Four Analysis Methods
Cardiovascular Magnetic Resonance to Predict Appropriate Implantable Cardioverter Defibrillator Therapy in Ischemic and Nonischemic Cardiomyopathy Patients Using Late Gadolinium Enhancement Border Zone Comparison of Four Analysis Methods
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DOI：
10.1161/circimaging.116.006105
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发表时间：
2017-09-01
影响因子：
7.5
通讯作者：
Carlsson, Marcus
中科院分区：
文献类型：
--
作者：
Jablonowski, Robert;Chaudhry, Uzma;Carlsson, Marcus
背景-心脏磁共振成像的晚期钆增强（LGE）边界区已被提议作为室性心律失常的独立预测因子。目的是确定 LGE 的大小和异质性是否可以预测缺血性心肌病 (ICM) 和非缺血性心肌病 (NICM) 患者的适当植入式心脏复律除颤器 (ICD) 治疗，并评估 4 种 LGE 边界区算法。 方法和结果 - 在 ICD 植入前接受 LGE 心脏磁共振成像的 ICM 和 NICM 患者 追溯纳入。将两种半自动算法（期望最大化、加权强度、先验信息和加权边界区域算法）与改进的全角半最大值算法和基于 2-3SD 阈值的算法 (2-3SD) 进行了比较。 LGE 每增加 1% 就计算危险比。总共对 74 例 ICM 和 34 例 NICM 进行了随访，随访时间分别为 63 个月（1-140）和 52 个月（0-133）。 ICM 患者发生了 27 起适当的 ICD 事件，NICM 患者发生了 7 起 ICD 事件。在采用主要预防性 ICD 的 ICM 患者中，LGE 边界区在单变量和多变量分析中预测 ICD 治疗，分析通过期望最大化、加权强度、先验信息、加权边界区和改进的全角半极大算法进行测量（风险比分别为 1.23、1.22 和 1.05；P
Background-Late gadolinium enhancement (LGE) border zone on cardiac magnetic resonance imaging has been proposed as an independent predictor of ventricular arrhythmias. The purpose was to determine whether size and heterogeneity of LGE predict appropriate implantable cardioverter defibrillator (ICD) therapy in ischemic cardiomyopathy (ICM) and nonischemic cardiomyopathy (NICM) patients and to evaluate 4 LGE border-zone algorithms.Methods and Results-ICM and NICM patients who underwent LGE cardiac magnetic resonance imaging prior to ICD implantation were retrospectively included. Two semiautomatic algorithms, expectation maximization, weighted intensity, a priori information and a weighted border zone algorithm, were compared with a modified full-width half-maximum and a 2-3SD threshold-based algorithm (2-3SD). Hazard ratios were calculated per 1% increase in LGE. A total of 74 ICM and 34 NICM were followed for 63 months (1-140) and 52 months (0-133), respectively. ICM patients had 27 appropriate ICD events, and NICM patients had 7 ICD events. In ICM patients with primary prophylactic ICD, LGE border zone predicted ICD therapy in univariable and multivariable analysis measured by the expectation maximization, weighted intensity, a priori information, weighted border zone, and modified full-width half-maximum algorithms (hazard ratios 1.23, 1.22, and 1.05, respectively; P