First-phase ejection fraction by cardiovascular magnetic resonance predicts outcomes in aortic stenosis
| العنوان: | First-phase ejection fraction by cardiovascular magnetic resonance predicts outcomes in aortic stenosis |
|---|---|
| المؤلفون: | Marc R. Dweck, Haotian Gu, John C. Chambers, Amedeo Chiribiri, Russell J. Everett, Eunsoo Park, Nick Spath, Calvin W. L. Chin, Lingyun Fang, Phil Chowienczyk, Rong Bing, David E. Newby, Audrey C. White |
| المصدر: | Journal of Cardiovascular Magnetic Resonance, Vol 23, Iss 1, Pp 1-11 (2021) Journal of Cardiovascular Magnetic Resonance |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Magnetic Resonance Spectroscopy, 030204 cardiovascular system & hematology, First-phase ejection fraction, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, Predictive Value of Tests, Internal medicine, medicine, Humans, Diseases of the circulatory (Cardiovascular) system, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, 030212 general & internal medicine, Systole, Angiology, Ejection fraction, Radiological and Ultrasound Technology, medicine.diagnostic_test, Proportional hazards model, business.industry, Research, Aortic stenosis, Hazard ratio, Stroke Volume, Magnetic resonance imaging, Aortic Valve Stenosis, medicine.disease, Stenosis, Echocardiography, Aortic Valve, RC666-701, cardiovascular system, Cardiology, Cardiovascular magnetic resonance, Cardiology and Cardiovascular Medicine, business |
| الوصف: | Background First-phase ejection fraction (EF1; the ejection fraction measured during active systole up to the time of maximal aortic flow) measured by transthoracic echocardiography (TTE) is a powerful predictor of outcomes in patients with aortic stenosis. We aimed to assess whether cardiovascular magnetic resonance (CMR) might provide more precise measurements of EF1 than TTE and to examine the correlation of CMR EF1 with measures of fibrosis. Methods In 141 patients with at least mild aortic stenosis, we measured CMR EF1 from a short-axis 3D stack and compared its variability with TTE EF1, and its associations with myocardial fibrosis and clinical outcome (aortic valve replacement (AVR) or death). Results Intra- and inter-observer variation of CMR EF1 (standard deviations of differences within and between observers of 2.3% and 2.5% units respectively) was approximately 50% that of TTE EF1. CMR EF1 was strongly predictive of AVR or death. On multivariable Cox proportional hazards analysis, the hazard ratio for CMR EF1 was 0.93 (95% confidence interval 0.89–0.97, p = 0.001) per % change in EF1 and, apart from aortic valve gradient, CMR EF1 was the only imaging or biochemical measure independently predictive of outcome. Indexed extracellular volume was associated with AVR or death, but not after adjusting for EF1. Conclusions EF1 is a simple robust marker of early left ventricular impairment that can be precisely measured by CMR and predicts outcome in aortic stenosis. Its measurement by CMR is more reproducible than that by TTE and may facilitate left ventricular structure–function analysis. |
| تدمد: | 1532-429X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9a8e0e59006e0bec080e62adde346fedTest https://doi.org/10.1186/s12968-021-00756-xTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....9a8e0e59006e0bec080e62adde346fed |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1532429X |
|---|