Myocardial Regional Interstitial Fibrosis is Associated With Left Intra-Ventricular Dyssynchrony in Patients With Heart Failure: A Cardiovascular Magnetic Resonance Study.
Myocardial Regional Interstitial Fibrosis is Associated With Left Intra-Ventricular Dyssynchrony in Patients With Heart Failure: A Cardiovascular Magnetic Resonance Study.
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DOI：
10.1038/srep20711
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发表时间：
2016-02-05
影响因子：
4.6
通讯作者：
Lin JL
中科院分区：
文献类型：
--
作者：
Lin LY;Wu CK;Juang JM;Wang YC;Su MY;Lai LP;Hwang JJ;Chiang FT;Tseng WY;Lin JL
左心室（LV）不同步与心力衰竭（HF）患者的不良预后相关。导致左心室不同步的机制尚未完全阐明。本研究评估间质纤维化的心肌区域变异是否与左心室不同步相关。 42 名收缩性心力衰竭 (SHF) 患者、76 名射血分数保留的心力衰竭 (HFpEF) 患者和 20 名无 HF 患者接受了心血管磁共振成像 (MRI) 研究。左室短轴观分为18段。在每个节段中，得出区域细胞外体积分数（ECV）和达到最小区域体积（Tmv）所需的时间。左心室内不同步由所有 Tmv 的最大差值 (Dysyn_max) 和标准差 (Dysyn_sd) 表示。结果显示，在协变量中，只有年龄（1.87，95%CI：0.61-3.13，p=0.004）和ECV（3.77，95%CI：2.72-4.81，p<0.001）与Tmv呈正相关。在某些亚组中，结果仍然稳健。总之，我们证明，无论左室整体功能如何，左室心肌间质纤维化的区域变异与左室心室内不同步密切相关。这些数据可能有助于解释左室不同步的病理生理学及其导致不良预后的潜在机制。
Left ventricular (LV) dyssynchrony is associated with poor prognosis in patients with heart failure (HF). The mechanisms leading to LV dyssynchrony are not fully elucidated. This study evaluates whether myocardium regional variation in interstitial fibrosis is associated with LV dyssynchrony. Forty-two patients with systolic heart failure (SHF), 76 patients with heart failure with preserved ejection fraction (HFpEF) and 20 patients without HF received cardiovascular magnetic resonance imaging (MRI) study. LV was divided into 18 segments by short-axis view. In each segment, regional extracellular volume fraction (ECV) and the time taken to reach minimum regional volume (Tmv) were derived. Intra-LV dyssynchrony were represented by maximum difference (Dysyn_max) and standard deviation (Dysyn_sd) of all Tmv. The results showed that among the covariates, only age (1.87, 95% CI: 0.61–3.13, p = 0.004) and ECV (3.77, 95% CI: 2.72–4.81, p < 0.001) were positively associated with Tmv. The results remained robust in certain subgroups. In conclusion, we demonstrated that LV myocardium regional variation in interstitial fibrosis is closely related to LV intra-ventricular dyssynchrony irrespective of the LV global function. These data might help explain the pathophysiology of LV dyssynchrony and it’s underlying mechanisms leading to poor prognosis.