Native Myocardial T1 Value in Predicting 1-Year Outcomes in Patients with Nonischemic Dilated Cardiomyopathy Experiencing Recent Heart Failure
Native Myocardial T1 Value in Predicting 1-Year Outcomes in Patients with Nonischemic Dilated Cardiomyopathy Experiencing Recent Heart Failure
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DOI：
10.1536/ihj.21-801
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发表时间：
2022-05-01
影响因子：
1.5
通讯作者：
Nakano, Yukiko
中科院分区：
文献类型：
--
作者：
Kitagawa, Toshiro;Tatsugami, Fuminari;Nakano, Yukiko
天然心肌T1值（T1（天然））的临床意义，特别是短期效用的证据。在非缺血性扩张型心肌病（NIDCM）的心脏磁共振（CMR）上缺乏。我们研究了T1（自体）评估近期发生心力衰竭（HF）的NIDCM患者左心室（LV）心肌特征和预测1年预后的潜力。45例3个月内出现NIDCM和HF症状的患者接受了CMR，包括电影、非造影T1标测和晚期钆增强（LGE）。每例患者的T1（自体）定义为基底部至心尖部LV心肌5个短轴切片的平均T1值。目视检查LGE的外观。赛德...与身高标准化左室舒张末期内径（LVEDD）相关（r = 0.38. P = 0.0103）、射血分数（r =-0.39，P = 0.009）和血清N末端脑钠肽前体水平（r = 0.48，P = 0.001），而LGE的存在和节段性程度仅与LVEDD相关。在1年随访队列中，预测LV反向重塑（LVRR）和联合心脏事件（心源性死亡、室性心动过速/颤动、心力衰竭住院）的T1（本地）最佳截止值分别为1366 ins和1377 ms。在多变量分析中，T1（天然）< 1366 ms和T1（天然）> 1377 ms仍然是LVRR（优势比，11.3）和心脏事件（风险比，11.3）的重要预测因子。近期发生HF的NIDCM患者的T1（自体）可能为评估LV心肌特征和预测1年LVRR和心脏事件提供有希望的策略。
The evidence for the clinical implications, especially the short-term utility, of native myocardial T1 value (T1(native)) ad. on cardiac magnetic resonance (CMR) in nonischemic dilated cardiomyopathy (NIDCM) is scant. We investigated the potential of T1(native) to assess left ventricular (LV) myocardial characteristics and predict 1-year outcomes in patient with NIDCM experiencing recent heart failure (HF).Forty-five patients with NIDCM and HF symptoms within 3 months underwent CMR with cine, non-contrast T1 mapping, and late gadolinium enhancement (LGE). T1(native) per patient was defined as an averaged T1 value of 5 short-axis slices of base-to-apex LV myocardium. The appearance of LGE was visually examined. Thad. correlated with the LV end-diastolic dimension normalized to height (LVEDD) (r = 0.38. P = 0.0103), ejection fraction (r = -0.39, P = 0.009), and serum N-terminal pro-brain natriuretic peptide levels (r = 0.48, P = 0.001), whereas the presence and segmental extent of LGE correlated only with LVEDD. In the 1-year follow-up cohort, the optimal cutoffs of T1(native) for predicting LV reverse remodeling (LVRR) and combined cardiac events (cardiac death, ventricular tachycardia/fibrillation, heart failure hospitalization) were 1366 ins and 1377 ms. respectively. In multivariate analysis, T1(native) < 1366 ms and T1(native) > 1377 ms remained significant predictors of LVRR (odds ratio, 11.3) and cardiac events (hazard ratio. 15.3), respectively, whereas the presence and segmental extent of LGE did not.T1(native) in patients with NIDCM experiencing recent HF may offer a promising strategy for assessing LV myocardial characteristics and predicting 1-year LVRR and cardiac events.