Myocardial fibrosis as a key determinant of left ventricular remodeling in idiopathic dilated cardiomyopathy: a contrast-enhanced cardiovascular magnetic study.

Détails

ID Serval
serval:BIB_0A8A639B8CBA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Myocardial fibrosis as a key determinant of left ventricular remodeling in idiopathic dilated cardiomyopathy: a contrast-enhanced cardiovascular magnetic study.
Périodique
Circulation. Cardiovascular imaging
Auteur(s)
Masci P.G., Schuurman R., Andrea B., Ripoli A., Coceani M., Chiappino S., Todiere G., Srebot V., Passino C., Aquaro G.D., Emdin M., Lombardi M.
ISSN
1942-0080 (Electronic)
ISSN-L
1941-9651
Statut éditorial
Publié
Date de publication
09/2013
Peer-reviewed
Oui
Volume
6
Numéro
5
Pages
790-799
Langue
anglais
Notes
Publication types: Journal Article ; Video-Audio Media
Publication Status: ppublish
Résumé
In idiopathic dilated cardiomyopathy, there are scarce data on the influence of late gadolinium enhancement (LGE) assessed by cardiovascular magnetic resonance on left ventricular (LV) remodeling.
Fifty-eight consecutive patients with idiopathic dilated cardiomyopathy underwent baseline clinical, biohumoral, and instrumental workup. Medical therapy was optimized after study enrollment. Cardiovascular magnetic resonance was used to assess ventricular volumes, function, and LGE extent at baseline and 24-month follow-up. LV reverse remodeling (RR) was defined as an increase in LV ejection fraction ≥10 U, combined with a decrease in LV end-diastolic volume ≥10% at follow-up. ΔLGE extent was the difference in LGE extent between follow-up and baseline. LV-RR was observed in 22 patients (38%). Multivariate regression analysis showed that the absence of LGE at baseline cardiovascular magnetic resonance was a strong predictor of LV-RR (odds ratio, 10.857 [95% confidence interval, 1.844-63.911]; P=0.008) after correction for age, heart rate, New York Heart Association class, LV volumes, and LV and right ventricular ejection fractions. All patients with baseline LGE (n=26; 45%) demonstrated LGE at follow-up, and no patient without baseline LGE developed LGE at follow-up. In LGE-positive patients, there was an increase in LGE extent over time (P=0.034), which was inversely related to LV ejection fraction variation (Spearman ρ, -0.440; P=0.041). Five patients showed an increase in LGE extent >75th percentile of ΔLGE extent, and among these none experienced LV-RR and 4 had a decrease in LV ejection fraction ≥10 U at follow-up.
In patients with idiopathic dilated cardiomyopathy, the absence of LGE at baseline is a strong independent predictor of LV-RR at 2-year follow-up, irrespective of the initial clinical status and the severity of ventricular dilatation and dysfunction. The increase in LGE extent during follow-up was associated with progressive LV dysfunction.

Mots-clé
Adult, Aged, Bayes Theorem, Cardiomyopathy, Dilated/diagnosis, Cardiomyopathy, Dilated/pathology, Cardiomyopathy, Dilated/physiopathology, Chi-Square Distribution, Contrast Media, Female, Fibrosis, Gadolinium DTPA, Humans, Logistic Models, Magnetic Resonance Imaging, Cine, Male, Middle Aged, Multivariate Analysis, Myocardium/pathology, Odds Ratio, Predictive Value of Tests, Prognosis, Risk Factors, Stroke Volume, Time Factors, Ventricular Dysfunction, Left/diagnosis, Ventricular Dysfunction, Left/pathology, Ventricular Dysfunction, Left/physiopathology, Ventricular Function, Left, Ventricular Function, Right, Ventricular Remodeling, cardiomyopathy, dilated, myocardial fibrosis, ventricular remodeling
Pubmed
Web of science
Création de la notice
25/08/2017 21:44
Dernière modification de la notice
20/08/2019 13:32
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