Comparison of cardiovascular magnetic resonance of late gadolinium enhancement and diastolic wall thickness to predict recovery of left ventricular function after coronary artery bypass surgery
Comparison of cardiovascular magnetic resonance of late gadolinium enhancement and diastolic wall thickness to predict recovery of left ventricular function after coronary artery bypass surgery
复制标题
DOI：
10.1186/1532-429x-10-41
复制
发表时间：
2008-09-22
影响因子：
6.4
通讯作者：
Chaithiraphan, Vithaya
中科院分区：
文献类型：
--
作者：
Krittayaphong, Rungroj;Laksanabunsong, Pansak;Chaithiraphan, Vithaya
背景：目的是比较通过心血管磁共振（CMR）评估的晚期钆增强（LGE）和舒张末期壁厚度（EDWT）在预测冠状动脉搭桥手术（CABG）后左心室功能恢复中的价值。方法：我们纳入了计划接受CABG的冠状动脉疾病且左心室射血分数<45%的患者。在基线和 CABG 后 4 个月通过电影 CMR 评估区域收缩性。 EDWT 和 LGE 在基线时进行评估。分析了区域收缩力改善的预测因素。结果：我们研究了 46 名男性和 4 名女性，平均年龄为 61 岁。基线左心室射血分数为 37 +/- 13%。总共分析了 2,020 个心肌节段。分别在 1,446 个节段 (71.6%) 和 1,196 个节段 (59.2%) 中检测到异常室壁运动和 LGE 区域。在基线时最初出现室壁运动异常的 1,227 个节段中，有 481 个节段 (39.2%) 表现出室壁运动改善。 Logistic 回归分析显示，LGE 面积、EDWT 和静息室壁运动等级可预测室壁运动的改善。接受者-操作者-特征 (ROC) 曲线的比较表明，LGE 面积是最重要的预测因子 (p < 0.001)。将 LGE 的信息添加到 EDWT 可以将单独 EDWT 的错误预测数量从 483 个节段减少到 127 个节段。结论：LGE 和 EDWT 是血运重建后功能恢复的独立预测因子。然而，LGE 似乎是一个更重要的因素并且独立于 EDWT。
Background: The objective was to compare the value of late gadolinium enhancement (LGE) and end-diastolic wall thickness (EDWT) assessed by cardiovascular magnetic resonance (CMR) in predicting recovery of left ventricular function after coronary artery bypass surgery (CABG).Methods: We enrolled patients with coronary artery disease and left ventricular ejection fraction < 45% who were scheduled for CABG. Regional contractility was assessed by cine CMR at baseline and 4 months after CABG. EDWT and LGE were assessed at baseline. Predictors for improvement of regional contractility were analyzed.Results: We studied 46 men and 4 women with an average age of 61 years. Baseline left ventricular ejection fraction was 37 +/- 13%. A total of 2,020 myocardial segments were analyzed. Abnormal wall motion and the LGE area were detected in 1,446 segments (71.6%) and 1,196 segments (59.2%) respectively. Wall motion improvement was demonstrated in 481 of 1,227 segments (39.2%) that initially had wall motion abnormalities at baseline. Logistic regression analysis showed that the LGE area, EDWT and resting wall motion grade predicted wall motion improvement. Comparison of Receiver-Operator-Characteristic (ROC) curves demonstrated that the LGE area was the most important predictor (p < 0.001). Adding information from LGE to the EDWT can decrease the number of false predictions by EDWT alone from 483 to 127 segments.Conclusion: LGE and EDWT are independent predictors for functional recovery after revascularization. However, LGE appears to be a more important factor and independent of EDWT.