Comparison of Systolic and Diastolic Criteria for Isolated LV Noncompaction in CMR
Comparison of Systolic and Diastolic Criteria for Isolated LV Noncompaction in CMR
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DOI：
10.1016/j.jcmg.2013.01.014
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发表时间：
2013-09-01
影响因子：
14
通讯作者：
Thohan, Vinay
中科院分区：
文献类型：
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作者：
Stacey, R. Brandon;Andersen, Mousumi M.;Thohan, Vinay
本研究使用心脏磁共振（CMR）比较左心室致密化不全（LVNC）的标准标准。超声心动图和CMR标准已建立诊断LVNC，但导致的诊断准确性concerns.Methods小梁/可能LVNC CMR回顾性观察了122例连续。我们比较了标准收缩末期非致密化与致密化比率（ESNCCR）、舒张末期非致密化与致密化比率（EDNCCR）和小梁质量与总质量比率（TMTMR）沿着死亡、栓塞事件、充血性心力衰竭（CHF）再入院、室性心律失常、心肌增厚（MT）、左心室射血分数（LVEF）、三维球度指数（3DSi）和左心室舒张末期容积指数。调整年龄、种族、性别、体表面积、糖尿病、高血压、高脂血症、冠状动脉疾病和CHF，使用logistic回归比较ESNCCR、EDNCCR和TMTMR之间的联合事件（死亡、CHF再入院、栓塞、室性心律失常）。调整相同的协变量，除了CHF，逻辑回归被用来比较CHF的几率为那些谁符合标准和那些谁没有。采用协方差分析法计算校正后的LVEF、MT、3DSi和左室舒张末期容积指数的平均值（8.6; 95%置信区间[CI]：2.5 - 33），对于超过艾德标准的组合事件（1.8; 95% CI：0.6 - 5.8）或TMTMR标准（3.14; 95% CI：1.09 - 10.2）。符合ESNCCR标准的患者发生CHF的比值比为29.4（95%CI：6.6 - 125），但符合EDNCCR标准的患者发生CHF的比值比为3.3（95%CI：1.1 - 9.2）。调整后，那些谁符合标准的致密化不全的ESNCCR有较低的LVEF和MT比那些谁没有（p = 0.01和p = 0.003，分别），但有没有差异，那些谁符合标准的EDNCCR或TMTMR标准和那些没有。结论ES措施LVNC有较强的关联事件，CHF，收缩功能障碍比其他措施。(c)2013年美国心脏病学会基金会
OBJECTIVES This study used cardiac magnetic resonance (CMR) to compare standard criteria for left ventricular noncompaction (LVNC).BACKGROUND LVNC as a distinct cardiomyopathy is supported by a growing number of publications. Echocardiographic and CMR criteria have been established to diagnosis LVNC but have led to concerns of diagnostic accuracy.METHODS Trabeculation/possible LVNC by CMR was retrospectively observed in 122 consecutive cases. We compared the standard end-systolic noncompacted-to-compacted ratio (ESNCCR), end-diastolic noncompacted:compacted ratio (EDNCCR), and trabecular mass-to-total mass ratio (TMTMR) along with deaths, embolic events, congestive heart failure (CHF) readmissions, ventricular arrhythmias, myocardial thickening (MT), left ventricular ejection fraction (LVEF), 3-dimensional sphericity index (3DSi), and left ventricular end-diastolic volume index. Adjusting for age, race, sex, body surface area, diabetes mellitus, hypertension, hyperlipidemia, coronary artery disease, and CHF, logistic regression was used to compare combined events (death, CHF readmission, embolism, ventricular arrhythmia) between ESNCCR, EDNCCR, and TMTMR. Adjusting for same covariates except CHF, logistic regression was used to compare the odds of CHF for those who met criteria and those who did not. Using analysis of covariance, adjusted means for LVEF, MT, 3DSi, and left ventricular end-diastolic volume index were generated.RESULTS ES criteria had a higher odds ratio (8.6; 95% confidence interval [CI]: 2.5 to 33) for combined events than ED criteria (1.8; 95% CI: 0.6 to 5.8) or TMTMR criteria (3.14; 95% CI: 1.09 to 10.2). The odds ratio of CHF for those who met ESNCCR criteria was 29.4 (95% CI: 6.6 to 125), but the odds ratio of CHF for those who met EDNCCR criteria was 3.3 (95% CI: 1.1 to 9.2). After adjustment, those who met criteria for noncompaction by ESNCCR had a lower LVEF and less MT than those who did not (p = 0.01 and p = 0.003, respectively), but there was no difference between those who met criteria for EDNCCR or the TMTMR criteria and those who did not.CONCLUSIONS ES measures of LVNC have stronger associations with events, CHF, and systolic dysfunction than other measures. (c) 2013 by the American College of Cardiology Foundation