目的探讨致心律失常性右室心肌病(ARVC)的心肌应变特点,根据修订后的工作队标准(rTFC),并探讨应变分析在ARVC中的预后价值。材料与方法这项回顾性研究包括247例患者(中位年龄,38年[IQR,28-48岁];167名男性,80名女性)诊断为ARVC,基于rTFC,2014年至2018年。患者分为“可能”(n=25),“边界线”(n=40),和rTFC后的“确定”(n=182)ARVC组。使用心脏MRI特征跟踪(FT)计算双心室全局应变参数。主要结局定义为心血管事件的复合,包括心血管死亡,心脏移植,和适当的植入式心律转复除颤器放电。采用单变量和多变量累积logistic回归和Cox比例风险回归分析评价右心室(RV)应变参数的诊断和预后价值。结果与可能组或临界组相比,明确ARVC患者在所有三个方向上的RV整体应变均显着降低(均P<.001)。RV整体纵向应变(GLS)是疾病的独立预测因子(比值比,1.09[95%CI:1.02,1.16];P=0.009)。在3.4年的中位随访期间(IQR,2.0-4.9年),55例患者出现主要终点事件。多变量分析表明,RVGLS与心血管事件的发生独立相关(风险比,1.15[95%CI:1.07,1.24];P<.001)。Kaplan-Meier分析显示,RVGLS比中位数更差的患者合并心血管事件的风险更高(log-rankP<.001)。结论来自心脏MRIFT的RVGLS对ARVC具有良好的诊断和预后价值。关键词:磁共振成像,图像后处理,心脏,右心室,心肌病,致心律失常性右心室心肌病,经修订的工作队标准,心血管MR,功能跟踪,心血管事件补充材料可用于本文。©RSNA,2024.
Purpose To demonstrate the myocardial strain characteristics of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC), based on revised Task Force Criteria (rTFC), and to explore the prognostic value of strain analysis in ARVC. Materials and Methods This retrospective study included 247 patients (median age, 38 years [IQR, 28-48 years]; 167 male, 80 female) diagnosed with ARVC, based on rTFC, between 2014 and 2018. Patients were divided into \"possible\" (n =25), \"borderline\" (n = 40), and \"definite\" (n = 182) ARVC groups following rTFC. Biventricular global strain parameters were calculated using cardiac MRI feature tracking (FT). The primary outcome was defined as a composite of cardiovascular events, including cardiovascular death, heart transplantation, and appropriate implantable cardioverter defibrillator discharge. Univariable and multivariable cumulative logistic regression and Cox proportional hazards regression analysis were used to evaluate the diagnostic and prognostic value of right ventricle (RV) strain parameters. Results Patients with definite ARVC had significantly reduced RV global strain in all three directions compared with possible or borderline groups (all P < .001). RV global longitudinal strain (GLS) was an independent predictor for disease (odds ratio, 1.09 [95% CI: 1.02, 1.16]; P = .009). During a median follow-up of 3.4 years (IQR, 2.0-4.9 years), 55 patients developed primary end point events. Multivariable analysis showed that RV GLS was independently associated with the occurrence of cardiovascular events (hazard ratio, 1.15 [95% CI: 1.07, 1.24]; P < .001). Kaplan-Meier analysis showed that patients with RV GLS worse than median had a higher risk of combined cardiovascular events (log-rank P < .001). Conclusion RV GLS derived from cardiac MRI FT demonstrated good diagnostic and prognostic value in ARVC. Keywords: MR Imaging, Image Postprocessing, Cardiac, Right Ventricle, Cardiomyopathies, Arrhythmogenic Right Ventricular Cardiomyopathy, Revised Task Force Criteria, Cardiovascular MR, Feature Tracking, Cardiovascular Events Supplemental material is available for this article. © RSNA, 2024.