心律失常性右室心肌病的心脏磁共振成像特征追踪和 T1 映射的增量预后价值

IF 3.8 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Radiology. Cardiothoracic imaging Pub Date : 2024-10-01 DOI:10.1148/ryct.230430
Guanyu Lu, Liqi Cao, Weitao Ye, Xiaoyu Wei, Jiajun Xie, Zhicheng Du, Xinyue Zhang, Xinyi Luo, Jiehao Ou, Qianhuan Zhang, Yang Liu, Yuelong Yang, Hui Liu
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Cox regression analysis was performed to assess the association between variables and time to sustained VA. Time-dependent receiver operating characteristic (ROC) analysis was performed to determine the incremental value of cardiac MRI FT and T1 mapping. Results During a median follow-up of 55.0 months (IQR, 37.0-76.0 months), 36 of 91 (40%) patients experienced sustained VA. A 1% worsening in left ventricular global longitudinal peak strain (GLS), 1% worsening in right ventricular GLS, and a 1% increase in extracellular volume fraction (ECV) were associated with increased risk of sustained VA, with hazard ratios of 1.14 (95% CI: 1.06, 1.23; <i>P</i> = .001), 1.09 (95% CI: 1.02, 1.16; <i>P</i> = .02), and 1.13 (95% CI: 1.08, 1.18; <i>P</i> < .001), respectively, after adjustment for ARVC risk score. Adding both biventricular GLS and ECV to ARVC risk score showed significant incremental value for predicting sustained VA (area under the ROC curve: 0.73 vs 0.65; <i>P</i> < .001). 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引用次数: 0

摘要

目的 探讨心脏磁共振成像特征追踪(FT)和 T1 映射在预测致心律失常性右室心肌病(ARVC)患者持续性室性心律失常(VA)中的作用,并研究其在 ARVC 风险评分之外可能的增量价值。材料与方法 该回顾性研究分析了 2010 年 11 月至 2022 年 3 月期间接受心脏磁共振成像检查的 91 例 ARVC 患者(中位年龄 36 岁 [IQR,27-50 岁];男性 60 例,女性 31 例)。主要终点是心脏磁共振成像后首次出现持续VA至首次VA,并对最后一次随访时未出现VA的存活患者进行普查。采用 Cox 回归分析评估变量与持续 VA 时间之间的关系。进行了时间依赖性接收器操作特征(ROC)分析,以确定心脏 MRI FT 和 T1 图谱的增量价值。结果 在中位随访 55.0 个月(IQR,37.0-76.0 个月)期间,91 例患者中有 36 例(40%)出现持续 VA。左心室整体纵向峰值应变(GLS)恶化 1%、右心室 GLS 恶化 1%、细胞外容积分数(ECV)增加 1%,均与持续 VA 风险增加有关,危险比为 1.调整 ARVC 风险评分后,危险比分别为 1.14 (95% CI: 1.06, 1.23; P = .001)、1.09 (95% CI: 1.02, 1.16; P = .02) 和 1.13 (95% CI: 1.08, 1.18; P < .001)。在 ARVC 风险评分的基础上增加双心室 GLS 和 ECV 可显著提高持续 VA 的预测价值(ROC 曲线下面积:0.73 vs 0.65;P < .001)。结论 在预测 ARVC 患者的持续 VA 方面,心脏 MRI 导出的双心室 GLS 和 ECV 可提供独立的增量价值,而不仅仅是 ARVC 风险评分。关键词心血管 MRI 特征追踪 T1 Mapping 致心律失常性右室心肌病 持续性室性心律失常 本文有补充材料,采用 CC BY 4.0 许可发布。
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Incremental Prognostic Value of Cardiac MRI Feature Tracking and T1 Mapping in Arrhythmogenic Right Ventricular Cardiomyopathy.

Purpose To explore the role of cardiac MRI feature tracking (FT) and T1 mapping in predicting sustained ventricular arrhythmias (VA) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) and to investigate their possible incremental value beyond ARVC risk score. Materials and Methods The retrospective study analyzed 91 patients with ARVC (median age, 36 years [IQR, 27-50 years]; 60 male, 31 female) who underwent cardiac MRI examinations between November 2010 and March 2022. The primary end point was the first occurrence of sustained VA after cardiac MRI to first VA, with censoring of patients who were alive without VA at last follow-up. Cox regression analysis was performed to assess the association between variables and time to sustained VA. Time-dependent receiver operating characteristic (ROC) analysis was performed to determine the incremental value of cardiac MRI FT and T1 mapping. Results During a median follow-up of 55.0 months (IQR, 37.0-76.0 months), 36 of 91 (40%) patients experienced sustained VA. A 1% worsening in left ventricular global longitudinal peak strain (GLS), 1% worsening in right ventricular GLS, and a 1% increase in extracellular volume fraction (ECV) were associated with increased risk of sustained VA, with hazard ratios of 1.14 (95% CI: 1.06, 1.23; P = .001), 1.09 (95% CI: 1.02, 1.16; P = .02), and 1.13 (95% CI: 1.08, 1.18; P < .001), respectively, after adjustment for ARVC risk score. Adding both biventricular GLS and ECV to ARVC risk score showed significant incremental value for predicting sustained VA (area under the ROC curve: 0.73 vs 0.65; P < .001). Conclusion Cardiac MRI-derived biventricular GLS and ECV provided independent and incremental value for predicting sustained VA beyond ARVC risk score alone in patients with ARVC. Keywords: Cardiovascular MRI, Feature Tracking, T1 Mapping, Arrhythmogenic Right Ventricular Cardiomyopathy, Sustained Ventricular Arrhythmias Supplemental material is available for this article Published under a CC BY 4.0 license.

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