Combination of extracellular volume fraction by cardiac magnetic resonance imaging and QRS duration for the risk stratification for patients with non-ischemic dilated cardiomyopathy
The extracellular volume fraction (ECV) by T1 mapping can quantify diffuse myocardial fibrosis, and useful as a non-invasive marker for risk stratification for patients with non-ischemic dilated cardiomyopathy (NIDCM). Prolonged QRS interval on electrocardiogram is related to worse clinical outcome...
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| Veröffentlicht in: | Heart and vessels 2020-10, Vol.35 (10), p.1439-1445 |
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| creator | Kodama, Sho Kato, Shingo Hayakawa, Keigo Azuma, Mai Kagimoto, Minako Iguchi, Kohei Fukuoka, Masahiro Fukui, Kazuki Iwasawa, Tae Utsunomiya, Daisuke Kosuge, Masami Kimura, Kazuo Tamura, Kouichi |
| description | The extracellular volume fraction (ECV) by T1 mapping can quantify diffuse myocardial fibrosis, and useful as a non-invasive marker for risk stratification for patients with non-ischemic dilated cardiomyopathy (NIDCM). Prolonged QRS interval on electrocardiogram is related to worse clinical outcome for heart failure patients. The purpose of this study was to evaluate the prognostic value of the combination of ECV and QRS duration for NIDCM patients. A total of 60 NIDCM patients (mean age 61 ± 12 years, mean left ventricular ejection fraction 37 ± 10%, mean QRS duration 110 ± 19 ms) were enrolled. Using a 1.5-T MR scanner and 32-channel cardiac coils, the mean ECV value of six myocardial segments at the mid-ventricular level was measured by the modified look-locker inversion recovery method. Adverse events were defined as follows: cardiac death; recurrent hospitalization due to heart failure. Patients were allocated into three groups based on ECV value and QRS duration (group 1: ECV ≦ 0.30 and QRS ≦ 120 ms; group 2: ECV > 0.30 or QRS > 120 ms; group 3: ECV > 0.30 and QRS > 120 ms). During a median follow-up duration of 370 days, 7 of 60 (12%) NIDCM patients experienced adverse events. NIDCM patients with events had longer QRS duration (134 ± 31 ms vs. 106 ± 14 ms,
p
= 0.01) and higher ECV (0.34 ± 0.07 vs 0.29 ± 0.05,
p
= 0.026) compared with those without events. On Kaplan–Meier curve analysis, significant difference was found between group 1 and group 3 (
p
|
| doi_str_mv | 10.1007/s00380-020-01618-9 |
| format | Article |
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p
= 0.01) and higher ECV (0.34 ± 0.07 vs 0.29 ± 0.05,
p
= 0.026) compared with those without events. On Kaplan–Meier curve analysis, significant difference was found between group 1 and group 3 (
p
< 0.001, log-rank test). No significant difference was found between group 1 and group 2 (
p
= 0.053), group 2 and group 3 (
p
= 0.115). The area under the receiver operating characteristic curve (AUC) for predicting adverse events was 0.778 (95% confidence interval CI 0.612–0.939) for ECV, 0.792 (95% CI 0.539–0.924) for QRS duration, 0.822 (95% CI 0.688–0.966) for combination of ECV and QRS duration. NIDCM patients with high ECV and prolonged QRS duration had significantly worse prognosis compared to those with normal ECV and normal QRS duration. The combination of ECV and QRS duration could be useful as a non-invasive method for better risk stratification for patients with NIDCM.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-020-01618-9</identifier><identifier>PMID: 32417957</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Action Potentials ; Aged ; Aged, 80 and over ; Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Cardiology ; Cardiomyopathy ; Cardiomyopathy, Dilated - diagnosis ; Cardiomyopathy, Dilated - pathology ; Cardiomyopathy, Dilated - physiopathology ; Confidence intervals ; Congestive heart failure ; Dilated cardiomyopathy ; Disease Progression ; EKG ; Electrocardiography ; Female ; Fibrosis ; Heart Conduction System - physiopathology ; Heart Disease Risk Factors ; Heart failure ; Heart Rate ; Humans ; Ischemia ; Magnetic resonance imaging ; Magnetic Resonance Imaging, Cine ; Male ; Mapping ; Medicine ; Medicine & Public Health ; Middle Aged ; Myocardium - pathology ; Original Article ; Predictive Value of Tests ; Prognosis ; Rank tests ; Reproducibility of Results ; Retrospective Studies ; Risk ; Risk Assessment ; Stroke Volume ; Vascular Surgery ; Ventricle ; Ventricular Function, Left</subject><ispartof>Heart and vessels, 2020-10, Vol.35 (10), p.1439-1445</ispartof><rights>Springer Japan KK, part of Springer Nature 2020</rights><rights>Springer Japan KK, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-9889aca7e4776e6c758a0acb03a934b2e713bfed57eeedfc9dd5344ca79b25c83</citedby><cites>FETCH-LOGICAL-c399t-9889aca7e4776e6c758a0acb03a934b2e713bfed57eeedfc9dd5344ca79b25c83</cites><orcidid>0000-0002-7545-0669</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-020-01618-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-020-01618-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32417957$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kodama, Sho</creatorcontrib><creatorcontrib>Kato, Shingo</creatorcontrib><creatorcontrib>Hayakawa, Keigo</creatorcontrib><creatorcontrib>Azuma, Mai</creatorcontrib><creatorcontrib>Kagimoto, Minako</creatorcontrib><creatorcontrib>Iguchi, Kohei</creatorcontrib><creatorcontrib>Fukuoka, Masahiro</creatorcontrib><creatorcontrib>Fukui, Kazuki</creatorcontrib><creatorcontrib>Iwasawa, Tae</creatorcontrib><creatorcontrib>Utsunomiya, Daisuke</creatorcontrib><creatorcontrib>Kosuge, Masami</creatorcontrib><creatorcontrib>Kimura, Kazuo</creatorcontrib><creatorcontrib>Tamura, Kouichi</creatorcontrib><title>Combination of extracellular volume fraction by cardiac magnetic resonance imaging and QRS duration for the risk stratification for patients with non-ischemic dilated cardiomyopathy</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>The extracellular volume fraction (ECV) by T1 mapping can quantify diffuse myocardial fibrosis, and useful as a non-invasive marker for risk stratification for patients with non-ischemic dilated cardiomyopathy (NIDCM). Prolonged QRS interval on electrocardiogram is related to worse clinical outcome for heart failure patients. The purpose of this study was to evaluate the prognostic value of the combination of ECV and QRS duration for NIDCM patients. A total of 60 NIDCM patients (mean age 61 ± 12 years, mean left ventricular ejection fraction 37 ± 10%, mean QRS duration 110 ± 19 ms) were enrolled. Using a 1.5-T MR scanner and 32-channel cardiac coils, the mean ECV value of six myocardial segments at the mid-ventricular level was measured by the modified look-locker inversion recovery method. Adverse events were defined as follows: cardiac death; recurrent hospitalization due to heart failure. Patients were allocated into three groups based on ECV value and QRS duration (group 1: ECV ≦ 0.30 and QRS ≦ 120 ms; group 2: ECV > 0.30 or QRS > 120 ms; group 3: ECV > 0.30 and QRS > 120 ms). During a median follow-up duration of 370 days, 7 of 60 (12%) NIDCM patients experienced adverse events. NIDCM patients with events had longer QRS duration (134 ± 31 ms vs. 106 ± 14 ms,
p
= 0.01) and higher ECV (0.34 ± 0.07 vs 0.29 ± 0.05,
p
= 0.026) compared with those without events. On Kaplan–Meier curve analysis, significant difference was found between group 1 and group 3 (
p
< 0.001, log-rank test). No significant difference was found between group 1 and group 2 (
p
= 0.053), group 2 and group 3 (
p
= 0.115). The area under the receiver operating characteristic curve (AUC) for predicting adverse events was 0.778 (95% confidence interval CI 0.612–0.939) for ECV, 0.792 (95% CI 0.539–0.924) for QRS duration, 0.822 (95% CI 0.688–0.966) for combination of ECV and QRS duration. NIDCM patients with high ECV and prolonged QRS duration had significantly worse prognosis compared to those with normal ECV and normal QRS duration. The combination of ECV and QRS duration could be useful as a non-invasive method for better risk stratification for patients with NIDCM.</description><subject>Action Potentials</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Cardiomyopathy</subject><subject>Cardiomyopathy, Dilated - diagnosis</subject><subject>Cardiomyopathy, Dilated - pathology</subject><subject>Cardiomyopathy, Dilated - physiopathology</subject><subject>Confidence intervals</subject><subject>Congestive heart failure</subject><subject>Dilated cardiomyopathy</subject><subject>Disease Progression</subject><subject>EKG</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Heart Conduction System - physiopathology</subject><subject>Heart Disease Risk Factors</subject><subject>Heart failure</subject><subject>Heart Rate</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging, Cine</subject><subject>Male</subject><subject>Mapping</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Myocardium - pathology</subject><subject>Original Article</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Rank tests</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk Assessment</subject><subject>Stroke Volume</subject><subject>Vascular Surgery</subject><subject>Ventricle</subject><subject>Ventricular Function, Left</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9u1DAQxi1ERbeFF-CALHHhEmrHyTo-ohVQpEqo_Dlbjj3ZdUnsxXaAfTDej9mmtBIHDpZHM7_5ZjQfIc85e80ZkxeZMdGxitX4-Jp3lXpEVhi0Vd1K8ZismOKs6kQtT8lZzjeM8VZx9YScirrhUrVyRX5v4tT7YIqPgcaBwq-SjIVxnEeT6I84zhPQAVO3QH-g1iTnjaWT2QYo3tIEOQYTLFCPOR-21ARHrz99pm5Oi-4QEy07oMnnbzSXY3bw9qG2xxBCyfSnLzsaYqh8tjuYUN350RRwy9g4HSKyu8NTcjKYMcOzu_-cfH339svmsrr6-P7D5s1VZYVSpVJdp4w1Ehop17C2su0MM7ZnwijR9DVILvoBXCsBwA1WOdeKpsEO1det7cQ5ebXo7lP8PkMuesLN8DomQJyzrhvWCKkkP6Iv_0Fv4pwCboeUkLzBWQ1S9ULZFHNOMOh9wrOlg-ZMH03Vi6kaTdW3pmqFTS_upOd-Anff8tdFBMQCZCyFLaSH2f-R_QPRrrIr</recordid><startdate>20201001</startdate><enddate>20201001</enddate><creator>Kodama, Sho</creator><creator>Kato, Shingo</creator><creator>Hayakawa, Keigo</creator><creator>Azuma, Mai</creator><creator>Kagimoto, Minako</creator><creator>Iguchi, Kohei</creator><creator>Fukuoka, Masahiro</creator><creator>Fukui, Kazuki</creator><creator>Iwasawa, Tae</creator><creator>Utsunomiya, Daisuke</creator><creator>Kosuge, Masami</creator><creator>Kimura, Kazuo</creator><creator>Tamura, Kouichi</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7545-0669</orcidid></search><sort><creationdate>20201001</creationdate><title>Combination of extracellular volume fraction by cardiac magnetic resonance imaging and QRS duration for the risk stratification for patients with non-ischemic dilated cardiomyopathy</title><author>Kodama, Sho ; Kato, Shingo ; Hayakawa, Keigo ; Azuma, Mai ; Kagimoto, Minako ; Iguchi, Kohei ; Fukuoka, Masahiro ; Fukui, Kazuki ; Iwasawa, Tae ; Utsunomiya, Daisuke ; Kosuge, Masami ; Kimura, Kazuo ; Tamura, Kouichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-9889aca7e4776e6c758a0acb03a934b2e713bfed57eeedfc9dd5344ca79b25c83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Action Potentials</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Cardiomyopathy</topic><topic>Cardiomyopathy, Dilated - diagnosis</topic><topic>Cardiomyopathy, Dilated - pathology</topic><topic>Cardiomyopathy, Dilated - physiopathology</topic><topic>Confidence intervals</topic><topic>Congestive heart failure</topic><topic>Dilated cardiomyopathy</topic><topic>Disease Progression</topic><topic>EKG</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Fibrosis</topic><topic>Heart Conduction System - physiopathology</topic><topic>Heart Disease Risk Factors</topic><topic>Heart failure</topic><topic>Heart Rate</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging, Cine</topic><topic>Male</topic><topic>Mapping</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Myocardium - pathology</topic><topic>Original Article</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Rank tests</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Risk Assessment</topic><topic>Stroke Volume</topic><topic>Vascular Surgery</topic><topic>Ventricle</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kodama, Sho</creatorcontrib><creatorcontrib>Kato, Shingo</creatorcontrib><creatorcontrib>Hayakawa, Keigo</creatorcontrib><creatorcontrib>Azuma, Mai</creatorcontrib><creatorcontrib>Kagimoto, Minako</creatorcontrib><creatorcontrib>Iguchi, Kohei</creatorcontrib><creatorcontrib>Fukuoka, Masahiro</creatorcontrib><creatorcontrib>Fukui, Kazuki</creatorcontrib><creatorcontrib>Iwasawa, Tae</creatorcontrib><creatorcontrib>Utsunomiya, Daisuke</creatorcontrib><creatorcontrib>Kosuge, Masami</creatorcontrib><creatorcontrib>Kimura, Kazuo</creatorcontrib><creatorcontrib>Tamura, Kouichi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kodama, Sho</au><au>Kato, Shingo</au><au>Hayakawa, Keigo</au><au>Azuma, Mai</au><au>Kagimoto, Minako</au><au>Iguchi, Kohei</au><au>Fukuoka, Masahiro</au><au>Fukui, Kazuki</au><au>Iwasawa, Tae</au><au>Utsunomiya, Daisuke</au><au>Kosuge, Masami</au><au>Kimura, Kazuo</au><au>Tamura, Kouichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Combination of extracellular volume fraction by cardiac magnetic resonance imaging and QRS duration for the risk stratification for patients with non-ischemic dilated cardiomyopathy</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2020-10-01</date><risdate>2020</risdate><volume>35</volume><issue>10</issue><spage>1439</spage><epage>1445</epage><pages>1439-1445</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>The extracellular volume fraction (ECV) by T1 mapping can quantify diffuse myocardial fibrosis, and useful as a non-invasive marker for risk stratification for patients with non-ischemic dilated cardiomyopathy (NIDCM). Prolonged QRS interval on electrocardiogram is related to worse clinical outcome for heart failure patients. The purpose of this study was to evaluate the prognostic value of the combination of ECV and QRS duration for NIDCM patients. A total of 60 NIDCM patients (mean age 61 ± 12 years, mean left ventricular ejection fraction 37 ± 10%, mean QRS duration 110 ± 19 ms) were enrolled. Using a 1.5-T MR scanner and 32-channel cardiac coils, the mean ECV value of six myocardial segments at the mid-ventricular level was measured by the modified look-locker inversion recovery method. Adverse events were defined as follows: cardiac death; recurrent hospitalization due to heart failure. Patients were allocated into three groups based on ECV value and QRS duration (group 1: ECV ≦ 0.30 and QRS ≦ 120 ms; group 2: ECV > 0.30 or QRS > 120 ms; group 3: ECV > 0.30 and QRS > 120 ms). During a median follow-up duration of 370 days, 7 of 60 (12%) NIDCM patients experienced adverse events. NIDCM patients with events had longer QRS duration (134 ± 31 ms vs. 106 ± 14 ms,
p
= 0.01) and higher ECV (0.34 ± 0.07 vs 0.29 ± 0.05,
p
= 0.026) compared with those without events. On Kaplan–Meier curve analysis, significant difference was found between group 1 and group 3 (
p
< 0.001, log-rank test). No significant difference was found between group 1 and group 2 (
p
= 0.053), group 2 and group 3 (
p
= 0.115). The area under the receiver operating characteristic curve (AUC) for predicting adverse events was 0.778 (95% confidence interval CI 0.612–0.939) for ECV, 0.792 (95% CI 0.539–0.924) for QRS duration, 0.822 (95% CI 0.688–0.966) for combination of ECV and QRS duration. NIDCM patients with high ECV and prolonged QRS duration had significantly worse prognosis compared to those with normal ECV and normal QRS duration. The combination of ECV and QRS duration could be useful as a non-invasive method for better risk stratification for patients with NIDCM.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>32417957</pmid><doi>10.1007/s00380-020-01618-9</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7545-0669</orcidid></addata></record> |
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| subjects | Action Potentials Aged Aged, 80 and over Biomedical Engineering and Bioengineering Cardiac Surgery Cardiology Cardiomyopathy Cardiomyopathy, Dilated - diagnosis Cardiomyopathy, Dilated - pathology Cardiomyopathy, Dilated - physiopathology Confidence intervals Congestive heart failure Dilated cardiomyopathy Disease Progression EKG Electrocardiography Female Fibrosis Heart Conduction System - physiopathology Heart Disease Risk Factors Heart failure Heart Rate Humans Ischemia Magnetic resonance imaging Magnetic Resonance Imaging, Cine Male Mapping Medicine Medicine & Public Health Middle Aged Myocardium - pathology Original Article Predictive Value of Tests Prognosis Rank tests Reproducibility of Results Retrospective Studies Risk Risk Assessment Stroke Volume Vascular Surgery Ventricle Ventricular Function, Left |
| title | Combination of extracellular volume fraction by cardiac magnetic resonance imaging and QRS duration for the risk stratification for patients with non-ischemic dilated cardiomyopathy |
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