Predictors of left ventricular remodelling in patients with dilated cardiomyopathy - a cardiovascular magnetic resonance study.
Dilated cardiomyopathy
Dobutamine stress
Myocardial remodelling
Recovery
Journal
European journal of heart failure
ISSN: 1879-0844
Titre abrégé: Eur J Heart Fail
Pays: England
ID NLM: 100887595
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
07
05
2019
revised:
05
07
2019
accepted:
29
11
2019
pubmed:
15
2
2020
medline:
20
5
2021
entrez:
15
2
2020
Statut:
ppublish
Résumé
There is an important need for better biomarkers to predict left ventricular (LV) remodelling in dilated cardiomyopathy (DCM). We undertook a comprehensive assessment of cardiac structure and myocardial composition to determine predictors of remodelling. Prospective study of patients with recent-onset DCM with cardiovascular magnetic resonance (CMR) assessment of ventricular structure and function, extracellular volume (T1 mapping), myocardial strain, myocardial scar (late gadolinium enhancement) and contractile reserve (dobutamine stress). Regression analyses were used to evaluate predictors of change in LV ejection fraction (LVEF) over 12 months. We evaluated 56 participants (34 DCM patients, median LVEF 43%; 22 controls). Absolute LV contractile reserve predicted change in LVEF (1% increase associated with 0.4% increase in LVEF at 12 months, P = 0.02). Baseline myocardial strain (P = 0.39 global longitudinal strain), interstitial myocardial fibrosis (P = 0.41), replacement myocardial fibrosis (P = 0.25), and right ventricular contractile reserve (P = 0.17) were not associated with LV reverse remodelling. There was a poor correlation between contractile reserve and either LV extracellular volume fraction (r = -0.22, P = 0.23) or baseline LVEF (r = 0.07, P = 0.62). Men were more likely to experience adverse LV remodelling (P = 0.01) but age (P = 0.88) and disease-modifying heart failure medication (beta-blocker, P = 0.28; angiotensin-converting enzyme inhibitor, P = 0.92) did not predict follow-up LVEF. Substantial recovery of LV function occurs within 12 months in most patients with recent-onset DCM. Women had the greatest improvement in LVEF. A low LV contractile reserve measured by dobutamine stress CMR appears to identify patients whose LVEF is less likely to recover.
Substances chimiques
Contrast Media
0
Gadolinium
AU0V1LM3JT
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1160-1170Subventions
Organisme : Medical Research Council UK
Pays : International
Organisme : Medical Research Council
ID : MR/M003191/1
Pays : United Kingdom
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Medical Research Council
ID : MC_U120085815
Pays : United Kingdom
Organisme : Harefield NHS Foundation Trust
Pays : International
Organisme : Imperial College London
Pays : International
Organisme : British Heart Foundation
ID : RG/19/1/34160
Pays : United Kingdom
Organisme : Rosetrees Trust
Pays : International
Organisme : Alexander Jansons Foundation
Pays : International
Organisme : Medical Research Council
ID : MC_UP_1102/20
Pays : United Kingdom
Organisme : NIHR Cardiovascular Biomedical Research Unit of Royal Brompton
Pays : International
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 European Society of Cardiology.
Références
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