Myocardial extracellular volume assessed by cardiovascular magnetic resonance may predict adverse left ventricular remodeling in rheumatic heart disease after valvular surgery

Quantitative Imaging in Medicine and Surgery

article

Shuang Li¹  Simeng Wang¹  Jianqun Yu¹  Jiayu Sun¹  Wei Cheng¹  Jing Liu¹  Huaxia Pu¹  Yucheng Chen²  Liqing Peng¹ 

[1] Department of Radiology, West China Hospital , Sichuan University;Department of Cardiology, West China Hospital , Sichuan University

关键词: Rheumatic heart disease (RHD);    left ventricular remodeling (LVR);    cardiac magnetic resonance (CMR);    myocardial fibrosis;    T1 mapping;   

DOI  :  10.21037/qims-21-678

学科分类：外科医学

来源: AME Publications

【 摘 要 】

Background: Only a few studies to date have focused on the application of cardiovascular magnetic resonance (CMR) in rheumatic heart disease (RHD); in particular, research on the application of T1-mapping CMR sequences is limited. This study aimed to investigate whether diffuse myocardial fibrosis evaluated using preoperative T1 mapping and extracellular volume (ECV) fraction measurement could predict the progression of adverse left ventricular remodeling (LVR) after surgery. Methods: 10% were classified into the adverse remodeling group; otherwise, patients were categorized into the non-adverse remodeling group. Results: Compared with the healthy controls, patients with RHD had impaired biventricular function, enlarged ventricular volume, and increased native T1 and ECV values. Patients in the adverse remodeling group had higher ECV values than those in the non-adverse remodeling group (33.25%±3.67% vs. 28.45%±4.46%, P=0.002). Binary logistic regression analysis showed that the ECV value was associated with adverse LVR (odds ratio: 1.273, P=0.045). ECV was found to be a sensitive biomarker for predicting adverse LVR (area under the curve: 0.78; sensitivity: 75.0%; specificity: 77.3%). Conclusions: ECV has potential value for predicting the progression of adverse LVR and for identifying non-responders among patients with RHD undergoing surgery.

【 授权许可】

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