Prognostic Significance of Left Ventricular Fibrosis Assessed by T1 Mapping in Patients with Atrial Fibrillation and Heart Failure
Prognostic Significance of Left Ventricular Fibrosis Assessed by T1 Mapping in Patients with Atrial Fibrillation and Heart Failure
复制标题
通过 T1 映射评估心房颤动和心力衰竭患者左心室纤维化的预后意义
DOI：
10.1038/s41598-019-49793-8
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发表时间：
2019-09-16
影响因子：
4.6
通讯作者：
Ma, Changsheng
中科院分区：
文献类型：
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作者：
Zhao, Lei;Li, Songnan;Ma, Changsheng
本研究旨在研究通过T1标测量化的左心室（LV）纤维化是否可用作预测房颤（AF）和心力衰竭（HF）患者结局的生物标志物。本研究纳入了108例AF和HF患者。2014年5月至2016年5月期间，他们接受了心脏磁共振，包括T1标测序列，以评估LV纤维化。患者接受房颤导管消融和HF药物治疗。主要终点为心源性死亡、后续HF或卒中的复合不良结局，后续HF为次要终点。在随访期间（中位数：23个月，Q1-Q3：11 - 28个月），发生了1例心源性死亡、12例卒中和42例HF发作。LV细胞外容积分数（ECV）预测复合不良结局和随后的HF（所有p < 0.001）。在多变量分析中，LV ECV是复合不良结局（风险比（HR）：1.258，95%置信区间（CI）：1.140-1.388，p < 0.001）和随后HF（HR：1.223，95% CI：1.098-1.363，p < 0.001）的独立预测因子。在AF和HF患者中，通过T1标测指数测量的LV纤维化可显著预测复合不良结局和随后的HF。
This study sought to investigate whether left ventricular (LV) fibrosis quantified by T1 mapping can be used as a biomarker to predict outcome in patients with atrial fibrillation (AF) and heart failure (HF). 108 patients with AF and HF were included in this study. They underwent cardiac magnetic resonance, including T1 mapping sequence to assess LV fibrosis between May 2014 to May 2016. Patients received catheter ablation for AF and pharmacological treatment for HF. The primary endpoint was a composite adverse outcome of cardiac death, subsequent HF or stroke, subsequent HF was the secondary endpoint. During follow up (median: 23 months, Q1-Q3: 11 to 28 months), 1 cardiac death, 12 strokes, and 42 HF episodes occurred. LV extracellular volume fraction (ECV) was predictive of composite adverse outcome and subsequent HF (all p < 0.001). In multivariable analysis, LV ECV was an independent predictor of composite adverse outcome (hazard ratio (HR): 1.258, 95% confidence interval (CI): 1.140–1.388, p < 0.001) and subsequent HF (HR: 1.223, 95% CI: 1.098–1.363, p < 0.001). LV fibrosis measured by T1 mapping indices significantly predicts composite adverse outcomes and subsequent HF in patients with AF and HF.