Dark papillary muscles sign is a new prognostic indicator in patients with dilated cardiomyopathy: A multi-center study
The prognostic value of left ventricular (LV) papillary muscle anomalies in dilated cardiomyopathy (DCM) patients is unclear. The objective of this study was to evaluate the prognostic significance of LV papillary muscle anomalies in DCM patients using cardiac magnetic resonance (CMR). 369 DCM patie...
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| Veröffentlicht in: | International journal of cardiology 2024-12, Vol.417, p.132583, Article 132583 |
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| creator | Shan, Rongxue Gao, Yan Wang, Wenxian Wang, Jian Li, Xiaofan Yuan, Xianshun Wang, Ximing |
| description | The prognostic value of left ventricular (LV) papillary muscle anomalies in dilated cardiomyopathy (DCM) patients is unclear. The objective of this study was to evaluate the prognostic significance of LV papillary muscle anomalies in DCM patients using cardiac magnetic resonance (CMR).
369 DCM patients who underwent CMR at two Chinese medical facilities from January 2019 to June 2023 were retrospectively and consecutively included in total. The various features of the LV papillary muscles were taken into consideration: thickness, attachment, supernumerary papillary muscles, angles, and signal intensity. The end-systolic signal hypointensity of both papillary muscles in early post-contrast cine CMR images was identified as Dark-Paps. Major adverse cardiac events (MACEs) were assessed, and all patients were followed up.
119 patients (32.2 %) had Dark-Paps and 141 patients (38.2 %) experienced MACE during a median follow-up of 22 months. According to Kaplan-Meier curve analysis, patients who had Dark-Paps had a lower survival rate free from MACE (log-rank, p |
| doi_str_mv | 10.1016/j.ijcard.2024.132583 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3107785453</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0167527324012051</els_id><sourcerecordid>3107785453</sourcerecordid><originalsourceid>FETCH-LOGICAL-c241t-a3bacc69c7d2de5a25178bdcc5b4b1f3471b6503b64f84efc46a9c8ad68413da3</originalsourceid><addsrcrecordid>eNp9kE1vFSEUhonRtNfaf2AMSzdzhQEGxoVJ09bWpIkbXRPmcKblOh9XYHpz_73cTHXpChKe9xzeh5D3nG05482n3TbswEW_rVktt1zUyohXZMONlhXXSr4mm4LpStVanJO3Ke0YY7JtzRk5F61gTW3aDTncuPiL7t0-DIOLRzouCQZMNIXHiYZEHZ3wQPdxfpzmlAPQMPkALs-x3EouB5xyooeQn6gPg8vo6elXYR6Pc3l-On6mV2XqkEMFBcVIU1788R1507sh4eXLeUF-fr39cX1fPXy_-3Z99VBBLXmunOgcQNOC9rVH5WrFtek8gOpkx3shNe8axUTXyN5I7EE2rgXjfGMkF96JC_JxnVsq_F4wZTuGBFjKTjgvyQrOtDZKKlFQuaIQ55Qi9nYfw1ikWM7sSbnd2VW5PSm3q_IS-_CyYelG9P9Cfx0X4MsKYOn5HDDaBMUaoA8RIVs_h_9v-APShpbB</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3107785453</pqid></control><display><type>article</type><title>Dark papillary muscles sign is a new prognostic indicator in patients with dilated cardiomyopathy: A multi-center study</title><source>Elsevier ScienceDirect Journals Complete</source><creator>Shan, Rongxue ; Gao, Yan ; Wang, Wenxian ; Wang, Jian ; Li, Xiaofan ; Yuan, Xianshun ; Wang, Ximing</creator><creatorcontrib>Shan, Rongxue ; Gao, Yan ; Wang, Wenxian ; Wang, Jian ; Li, Xiaofan ; Yuan, Xianshun ; Wang, Ximing</creatorcontrib><description>The prognostic value of left ventricular (LV) papillary muscle anomalies in dilated cardiomyopathy (DCM) patients is unclear. The objective of this study was to evaluate the prognostic significance of LV papillary muscle anomalies in DCM patients using cardiac magnetic resonance (CMR).
369 DCM patients who underwent CMR at two Chinese medical facilities from January 2019 to June 2023 were retrospectively and consecutively included in total. The various features of the LV papillary muscles were taken into consideration: thickness, attachment, supernumerary papillary muscles, angles, and signal intensity. The end-systolic signal hypointensity of both papillary muscles in early post-contrast cine CMR images was identified as Dark-Paps. Major adverse cardiac events (MACEs) were assessed, and all patients were followed up.
119 patients (32.2 %) had Dark-Paps and 141 patients (38.2 %) experienced MACE during a median follow-up of 22 months. According to Kaplan-Meier curve analysis, patients who had Dark-Paps had a lower survival rate free from MACE (log-rank, p < 0.001). Dark-Paps maintained an independent predictor of MACE in a multivariate model that included left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE) extent (HR: 3.49; p < 0.001). Furthermore, adding Dark-Paps to the multivariate model greatly enhanced the prognostic role of endpoint events (C-statistic improvement: 0.652–0.777, Delong test: p < 0.001).
Dark-Paps is a potent independent indicator of major adverse cardiac events in dilated cardiomyopathy patients. In addition, Dark-Paps can provide additional prognostic value over the multivariable baseline clinical model.
[Display omitted]
•Papillary muscle anomalies are observed in DCM patients.•In DCM patients, Dark-Paps is a new indicator of prognosis.•Dark-Paps played an additive prognostic role for the multivariate model that included LVEF and LGE extent.</description><identifier>ISSN: 0167-5273</identifier><identifier>ISSN: 1874-1754</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2024.132583</identifier><identifier>PMID: 39306289</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Cardiac magnetic resonance ; Dilated cardiomyopathy ; Major adverse cardiac events ; Prognosis</subject><ispartof>International journal of cardiology, 2024-12, Vol.417, p.132583, Article 132583</ispartof><rights>2024 Elsevier B.V.</rights><rights>Copyright © 2024. Published by Elsevier B.V.</rights><rights>Copyright © 2024 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c241t-a3bacc69c7d2de5a25178bdcc5b4b1f3471b6503b64f84efc46a9c8ad68413da3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijcard.2024.132583$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39306289$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shan, Rongxue</creatorcontrib><creatorcontrib>Gao, Yan</creatorcontrib><creatorcontrib>Wang, Wenxian</creatorcontrib><creatorcontrib>Wang, Jian</creatorcontrib><creatorcontrib>Li, Xiaofan</creatorcontrib><creatorcontrib>Yuan, Xianshun</creatorcontrib><creatorcontrib>Wang, Ximing</creatorcontrib><title>Dark papillary muscles sign is a new prognostic indicator in patients with dilated cardiomyopathy: A multi-center study</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>The prognostic value of left ventricular (LV) papillary muscle anomalies in dilated cardiomyopathy (DCM) patients is unclear. The objective of this study was to evaluate the prognostic significance of LV papillary muscle anomalies in DCM patients using cardiac magnetic resonance (CMR).
369 DCM patients who underwent CMR at two Chinese medical facilities from January 2019 to June 2023 were retrospectively and consecutively included in total. The various features of the LV papillary muscles were taken into consideration: thickness, attachment, supernumerary papillary muscles, angles, and signal intensity. The end-systolic signal hypointensity of both papillary muscles in early post-contrast cine CMR images was identified as Dark-Paps. Major adverse cardiac events (MACEs) were assessed, and all patients were followed up.
119 patients (32.2 %) had Dark-Paps and 141 patients (38.2 %) experienced MACE during a median follow-up of 22 months. According to Kaplan-Meier curve analysis, patients who had Dark-Paps had a lower survival rate free from MACE (log-rank, p < 0.001). Dark-Paps maintained an independent predictor of MACE in a multivariate model that included left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE) extent (HR: 3.49; p < 0.001). Furthermore, adding Dark-Paps to the multivariate model greatly enhanced the prognostic role of endpoint events (C-statistic improvement: 0.652–0.777, Delong test: p < 0.001).
Dark-Paps is a potent independent indicator of major adverse cardiac events in dilated cardiomyopathy patients. In addition, Dark-Paps can provide additional prognostic value over the multivariable baseline clinical model.
[Display omitted]
•Papillary muscle anomalies are observed in DCM patients.•In DCM patients, Dark-Paps is a new indicator of prognosis.•Dark-Paps played an additive prognostic role for the multivariate model that included LVEF and LGE extent.</description><subject>Cardiac magnetic resonance</subject><subject>Dilated cardiomyopathy</subject><subject>Major adverse cardiac events</subject><subject>Prognosis</subject><issn>0167-5273</issn><issn>1874-1754</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kE1vFSEUhonRtNfaf2AMSzdzhQEGxoVJ09bWpIkbXRPmcKblOh9XYHpz_73cTHXpChKe9xzeh5D3nG05482n3TbswEW_rVktt1zUyohXZMONlhXXSr4mm4LpStVanJO3Ke0YY7JtzRk5F61gTW3aDTncuPiL7t0-DIOLRzouCQZMNIXHiYZEHZ3wQPdxfpzmlAPQMPkALs-x3EouB5xyooeQn6gPg8vo6elXYR6Pc3l-On6mV2XqkEMFBcVIU1788R1507sh4eXLeUF-fr39cX1fPXy_-3Z99VBBLXmunOgcQNOC9rVH5WrFtek8gOpkx3shNe8axUTXyN5I7EE2rgXjfGMkF96JC_JxnVsq_F4wZTuGBFjKTjgvyQrOtDZKKlFQuaIQ55Qi9nYfw1ikWM7sSbnd2VW5PSm3q_IS-_CyYelG9P9Cfx0X4MsKYOn5HDDaBMUaoA8RIVs_h_9v-APShpbB</recordid><startdate>20241215</startdate><enddate>20241215</enddate><creator>Shan, Rongxue</creator><creator>Gao, Yan</creator><creator>Wang, Wenxian</creator><creator>Wang, Jian</creator><creator>Li, Xiaofan</creator><creator>Yuan, Xianshun</creator><creator>Wang, Ximing</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20241215</creationdate><title>Dark papillary muscles sign is a new prognostic indicator in patients with dilated cardiomyopathy: A multi-center study</title><author>Shan, Rongxue ; Gao, Yan ; Wang, Wenxian ; Wang, Jian ; Li, Xiaofan ; Yuan, Xianshun ; Wang, Ximing</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c241t-a3bacc69c7d2de5a25178bdcc5b4b1f3471b6503b64f84efc46a9c8ad68413da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Cardiac magnetic resonance</topic><topic>Dilated cardiomyopathy</topic><topic>Major adverse cardiac events</topic><topic>Prognosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shan, Rongxue</creatorcontrib><creatorcontrib>Gao, Yan</creatorcontrib><creatorcontrib>Wang, Wenxian</creatorcontrib><creatorcontrib>Wang, Jian</creatorcontrib><creatorcontrib>Li, Xiaofan</creatorcontrib><creatorcontrib>Yuan, Xianshun</creatorcontrib><creatorcontrib>Wang, Ximing</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shan, Rongxue</au><au>Gao, Yan</au><au>Wang, Wenxian</au><au>Wang, Jian</au><au>Li, Xiaofan</au><au>Yuan, Xianshun</au><au>Wang, Ximing</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dark papillary muscles sign is a new prognostic indicator in patients with dilated cardiomyopathy: A multi-center study</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2024-12-15</date><risdate>2024</risdate><volume>417</volume><spage>132583</spage><pages>132583-</pages><artnum>132583</artnum><issn>0167-5273</issn><issn>1874-1754</issn><eissn>1874-1754</eissn><abstract>The prognostic value of left ventricular (LV) papillary muscle anomalies in dilated cardiomyopathy (DCM) patients is unclear. The objective of this study was to evaluate the prognostic significance of LV papillary muscle anomalies in DCM patients using cardiac magnetic resonance (CMR).
369 DCM patients who underwent CMR at two Chinese medical facilities from January 2019 to June 2023 were retrospectively and consecutively included in total. The various features of the LV papillary muscles were taken into consideration: thickness, attachment, supernumerary papillary muscles, angles, and signal intensity. The end-systolic signal hypointensity of both papillary muscles in early post-contrast cine CMR images was identified as Dark-Paps. Major adverse cardiac events (MACEs) were assessed, and all patients were followed up.
119 patients (32.2 %) had Dark-Paps and 141 patients (38.2 %) experienced MACE during a median follow-up of 22 months. According to Kaplan-Meier curve analysis, patients who had Dark-Paps had a lower survival rate free from MACE (log-rank, p < 0.001). Dark-Paps maintained an independent predictor of MACE in a multivariate model that included left ventricular ejection fraction (LVEF) and late gadolinium enhancement (LGE) extent (HR: 3.49; p < 0.001). Furthermore, adding Dark-Paps to the multivariate model greatly enhanced the prognostic role of endpoint events (C-statistic improvement: 0.652–0.777, Delong test: p < 0.001).
Dark-Paps is a potent independent indicator of major adverse cardiac events in dilated cardiomyopathy patients. In addition, Dark-Paps can provide additional prognostic value over the multivariable baseline clinical model.
[Display omitted]
•Papillary muscle anomalies are observed in DCM patients.•In DCM patients, Dark-Paps is a new indicator of prognosis.•Dark-Paps played an additive prognostic role for the multivariate model that included LVEF and LGE extent.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>39306289</pmid><doi>10.1016/j.ijcard.2024.132583</doi></addata></record> |
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| subjects | Cardiac magnetic resonance Dilated cardiomyopathy Major adverse cardiac events Prognosis |
| title | Dark papillary muscles sign is a new prognostic indicator in patients with dilated cardiomyopathy: A multi-center study |
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