Left atrial function predicts outcome in dilated cardiomyopathy: fast long-axis strain analysis derived from MRI

Y Li, Y Xu, S Tang, X Jiang, W Li, J Guo, F Yang, Z Xu… - Radiology, 2022 - pubs.rsna.org
Y Li, Y Xu, S Tang, X Jiang, W Li, J Guo, F Yang, Z Xu, J Sun, Y Han, Y Zhu, Y Chen
Radiology, 2022pubs.rsna.org
Background There is increasing recognition that left atrial (LA) function is prognostically
important in cardiovascular disease. LA strain is a sensitive parameter to describe complex
LA phasic function. However, the prognostic value of LA strain in participants with idiopathic
dilated cardiomyopathy (DCM) remains unclear. Purpose To evaluate the prognostic value
of LA strain derived from cardiac MRI in study participants with idiopathic DCM. Materials
and Methods Participants with idiopathic DCM who underwent cardiac MRI between June …
Background
There is increasing recognition that left atrial (LA) function is prognostically important in cardiovascular disease. LA strain is a sensitive parameter to describe complex LA phasic function. However, the prognostic value of LA strain in participants with idiopathic dilated cardiomyopathy (DCM) remains unclear.
Purpose
To evaluate the prognostic value of LA strain derived from cardiac MRI in study participants with idiopathic DCM.
Materials and Methods
Participants with idiopathic DCM who underwent cardiac MRI between June 2012 and November 2018 were prospectively enrolled. The fast long-axis strain MRI method was performed to assess LA strain. The primary end point was all-cause mortality and heart transplant, and the secondary end point was a combination of primary end point, heart failure readmission, and aborted sudden cardiac death. Cox regression analyses and Kaplan-Meier survival analysis were performed to identify the association between variables and outcomes.
Results
There were 497 participants (mean age, 47 years ± 14 [standard deviation]; 357 men) evaluated. During a median follow-up of 36 months (interquartile range, 26–54 months), 113 participants reached primary end points and 203 participants reached secondary end points. LA reservoir, conduit and booster strain, and strain rate were lower in participants with primary end points (P < .001). In multivariable Cox regression analysis, LA reservoir strain and conduit strain were independent predictors for primary end point (hazard ratio [HR] per 1% increase, 0.95 [95% CI: 0.91, 0.99; P = .008] and 0.92 [95% CI: 0.87, 0.98; P = .010], respectively) and secondary end points (HR per 1% increase, 0.95 [95% CI: 0.93, 0.97; P < .001] and 0.93 [95% CI: 0.89, 0.97; P < .001], respectively). In addition, LA reservoir strain and conduit strain added incremental prognostic value to clinical risk factors and late gadolinium enhancement presence (all, P < .05).
Conclusion
Left atrial reservoir and conduit strain, derived from cardiac MRI by using the fast long-axis method, were independent predictors of adverse clinical outcomes in idiopathic dilated cardiomyopathy.
© RSNA, 2021
See also the editorial by Ambale-Venkatesh in this issue.
Radiological Society of North America
以上显示的是最相近的搜索结果。 查看全部搜索结果