Right Ventricular Abnormalities on Cardiovascular Magnetic Resonance Imaging in Patients With Sarcoidosis.
Right Ventricular Abnormalities on Cardiovascular Magnetic Resonance Imaging in Patients With Sarcoidosis.
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DOI：
10.1016/j.jcmg.2019.12.011
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发表时间：
2020-06
影响因子：
14
通讯作者：
Shenoy, Chetan
中科院分区：
文献类型：
--
作者：
Velangi, Pratik S.;Chen, Ko-Hsuan Amy;Kazmirczak, Felipe;Okasha, Osama;von Wald, Lisa;Roukoz, Henri;Farzaneh-Far, Afshin;Markowitz, Jeremy;Nijjar, Prabhjot S.;Bhargava, Maneesh;Perlman, David;Akcakaya, Mehmet;Shenoy, Chetan
关键词：
在结节病患者中，右心室（RV）异常已经在许多成像方式上被描述。在心血管磁共振（CMR）上，右心室异常包括量化为右心室射血分数（RVEF）异常的右心室收缩功能障碍和右心室晚期钆增强（LGE）。我们的目的是确定右心室收缩功能障碍和右心室LGE的CMR患病率，它们的决定因素，以及它们对结节病患者长期不良结局的影响。我们研究了连续的活检证实结节病的患者，他们因怀疑心脏受累而接受CMR。对他们进行了两个终点的随访：全因死亡和心源性猝死或显著室性心律失常的复合心律失常终点。290例患者中，右心室收缩功能障碍（男性RVEF <40%，女性<45%）和右心室LGE分别为35例（12.1%）和16例（5.5%）。全因死亡的中位随访时间为3.2年（四分位数范围1.6至5.7年），心律失常终点的中位随访时间为3.0年（四分位数范围1.4至5.5年）。在Cox比例风险回归多变量分析中，在调整LVEF、LV LGE程度和RV LGE存在后，只有RVEF与全因死亡独立相关（每降低1%的HR为1.05；95% CI为1.01-1.09;p=0.022）。RVEF与心律失常终点无相关性（HR 1.01; 95% CI 0.96-1.06; p=0.67）。相反，RV LGE与全因死亡无关（HR 2.78; 95% CI 0.36-21.66; p=0.33），但与心律失常终点独立相关（HR 5.43; 95% CI 1.25-23.47; p=0.024）。在我们对结节病患者的研究中，右心室收缩功能障碍和右心室LGE具有明显的预后相关性；右心室收缩功能障碍而非右心室LGE与全因死亡独立相关，而右心室LGE而非右心室收缩功能障碍与心源性猝死或显著室性心律失常独立相关。我们的研究结果可能对结节病中右心室异常的处理有不同的意义。
In patients with sarcoidosis, right ventricular (RV) abnormalities have been described on many imaging modalities. On cardiovascular magnetic resonance (CMR), RV abnormalities include RV systolic dysfunction quantified as an abnormal RV ejection fraction (RVEF), and RV late gadolinium enhancement (LGE). We aimed to determine the prevalence on CMR of RV systolic dysfunction and RV LGE, their determinants, and their impact on long-term adverse outcomes in patients with sarcoidosis. We studied consecutive patients with biopsy-proven sarcoidosis who underwent CMR for suspected cardiac involvement. They were followed for two endpoints: all-cause death, and a composite arrhythmic endpoint of sudden cardiac death or significant ventricular arrhythmia. Among 290 patients, RV systolic dysfunction (RVEF <40% in men and <45% in women) and RV LGE were present in 35 (12.1%) and 16 (5.5%) respectively. The median follow-up time was 3.2 years (interquartile range 1.6 to 5.7 years) for all-cause death and 3.0 years (interquartile range 1.4 to 5.5 years) for the arrhythmic endpoint. On Cox proportional hazards regression multivariable analyses, only RVEF was independently associated with all-cause death (HR 1.05 for every 1% decrease; 95% CI 1.01–1.09; p=0.022) after adjustment for LVEF, LV LGE extent, and the presence of RV LGE. RVEF was not associated with the arrhythmic endpoint (HR 1.01; 95% CI 0.96–1.06; p=0.67). Conversely, RV LGE was not associated with all-cause death (HR 2.78; 95% CI 0.36–21.66; p=0.33), while it was independently associated with the arrhythmic endpoint (HR 5.43; 95% CI 1.25–23.47; p=0.024). In our study of patients with sarcoidosis, RV systolic dysfunction and RV LGE had distinct prognostic associations; RV systolic dysfunction but not RV LGE was independently associated with all-cause death, while RV LGE but not RV systolic dysfunction was independently associated with sudden cardiac death or significant ventricular arrhythmia. Our findings may indicate distinct implications for the management of RV abnormalities in sarcoidosis.
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影响因子：
4.9
作者：
Baughman RP
通讯作者：
Baughman RP
影响因子：
5.4
作者：
Ekström K;Lehtonen J;Hänninen H;Kandolin R;Kivistö S;Kupari M
通讯作者：
Kupari M
影响因子：
9.6
作者：
Baughman, Robert P.;Engel, Peter J.;Lower, Elyse E.
通讯作者：
Lower, Elyse E.
影响因子：
9.6
作者：
BAUGHMAN, RP;GERSON, M;BOSKEN, CH
通讯作者：
BOSKEN, CH
DOI：
10.1016/j.echo.2016.06.001
发表时间：
2016-09-01
影响因子：
6.5
作者：
Joyce, Emer;Kamperidis, Vasileios;Marsan, Nina Ajmone
通讯作者：
Marsan, Nina Ajmone