Novel Predictors of Left Ventricular Reverse Remodeling in Individuals With Recent-Onset Dilated Cardiomyopathy

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:61

Article

Kubanek, Milos¹  Sramko, Marek²  Maluskova, Jana³  Kautznerova, Dana⁴  Weichet, Jiri¹  Lupinek, Petr¹  Vrbska, Jana¹  Malek, Ivan¹  Kautzner, Josef¹ 

[1] Inst Clin & Expt Med, Dept Cardiol, Prague, Czech Republic

[2] Inst Clin & Expt Med, Dept Pathol, Prague, Czech Republic

[3] Inst Clin & Expt Med, Dept Radiol, Prague, Czech Republic

[4] Na Homolce Hosp, Dept Radiol, Prague, Czech Republic

关键词: biomarkers;    cardiovascular magnetic resonance;    endomyocardial biopsy;    left ventricular reverse remodeling;    recent-onset dilated cardiomyopathy;   

DOI  :  10.1016/j.jacc.2012.07.072

来源: Elsevier

【 摘 要 】

Objectives This study aimed to evaluate the performance of cardiac magnetic resonance (CMR), cardiac biomarkers, and endomyocardial biopsy (EMB) results to predict left ventricular reverse remodeling (LVRR) in individuals with recent-onset dilated cardiomyopathy (DCM). Background LVRR is a marker of a favorable prognosis in individuals with recent-onset DCM. We used the aforementioned novel methods of prognostication to predict this event. Methods A total of 44 consecutive patients with recent-onset DCM underwent at baseline CMR, measurement of biomarkers and EMB together with conventional methods, including cardiopulmonary exercise testing and echocardiography. Measurement of B-type natriuretic peptide (BNP) and the cardiological examination were repeated at 3, 6, and 12 months. CMR was repeated at 12 months. LVRR was defined as an absolute increase in left ventricular ejection fraction from >= 10% to a final value of >35% accompanied by a decrease in left ventricular end-diastolic dimension >= 10% at 12 months of follow-up. Results LVRR was observed in 20 individuals (45%) at 12 months. At baseline, a lower extent of late gadolinium enhancement (odds ratio [OR]: 0.67 [95% confidence interval (CI): 0.50 to 0.90]; p = 0.008) and a higher myocardial edema ratio (OR: 1.45 [95% CI: 1.04 to 2.02]; p = 0.027) measured by CMR were independent predictors of LVRR. At 3 months, the latest BNP plasma level (OR: 0.14 [95% CI: 0.02 to 0.94] per log BNP; p = 0.047) was the strongest predictor of LVRR. Conclusions Both CMR and serial BNP testing provide a better prediction of LVRR in recent-onset DCM than EMB results, other biomarkers, and the conventional methods of follow-up. (J Am Coll Cardiol 2013;61:54-63) (C) 2013 by the American College of Cardiology Foundation

【 授权许可】

Free