The Prognostic Value of Left Ventricular Mechanical Dyssynchrony                     Derived from Cardiac MRI in Patients with Idiopathic Dilated                     Cardiomyopathy

Li, Yangjie; Liu, Xiumin; Xu, Yuanwei; Li, Weihao; Tang, Siqi; Zhou, Xiaoyue; Sun, Jiayu; Zhang, Qing; Han, Yuchi; Chen, Yu‐Cheng

doi:10.1148/ryct.2021200536

Cited by 5 publications

(2 citation statements)

References 32 publications

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“…Left ventricular mechanical dyssynchrony is known to be associated with adverse events [ 1 , 2 ]. Phase variables, a marker of the dyssynchrony, can be assessed by ECG-gated single photon emission computed tomography (SPECT) and positron emission tomography (PET) myocardial perfusion imaging (MPI) [ 3 – 5 ].…”

Section: Introductionmentioning

confidence: 99%

Incremental prognostic value of stress phase entropy over standard PET myocardial perfusion imaging variables

Kuronuma

Miller

Kriekinge

et al. 2023

Eur J Nucl Med Mol Imaging

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Purpose Phase analysis can assess left ventricular dyssynchrony. The independent prognostic value of phase variables over positron emission tomography myocardial perfusion imaging (PET-MPI) variables including myocardial flow reserve (MFR) has not been studied. The aim of this study was to explore the prognostic value of phase variables for predicting mortality over standard PET-MPI variables. Methods Consecutive patients who underwent pharmacological stress-rest 82Rb PET study were enrolled. All PET-MPI variables including phase variables (phase entropy, phase bandwidth, and phase standard deviation) were automatically obtained by QPET software (Cedars-Sinai, Los Angeles, CA). Cox proportional hazard analyses were used to assess associations with all-cause mortality (ACM). Results In a total of 3963 patients (median age 71 years; 57% male), 923 patients (23%) died during a median follow-up of 5 years. Annualized mortality rates increased with stress phase entropy, with a 4.6-fold difference between the lowest and highest decile groups of entropy (2.6 vs. 12.0%/year). Abnormal stress phase entropy (optimal cutoff value, 43.8%) stratified ACM risk in patients with normal and impaired MFR (both p < 0.001). Among three phase variables, only stress phase entropy was significantly associated with ACM after the adjustment of standard clinical and PET-MPI variables including MFR and stress-rest change of phase variables, whether modeled as binary variables (adjusted hazard ratio, 1.44 for abnormal entropy [> 43.8%]; 95%CI, 1.18–1.75; p < 0.001) or continuous variables (adjusted hazard ratio, 1.05 per 5% increase; 95%CI, 1.01–1.10; p = 0.030). The addition of stress phase entropy to the standard PET-MPI variables significantly improved the discriminatory power for ACM prediction (p < 0.001), but the other phase variables did not (p > 0.1). Conclusion Stress phase entropy is independently and incrementally associated with ACM beyond standard PET-MPI variables including MFR. Phase entropy can be obtained automatically and included in clinical reporting of PET-MPI studies to improve patient risk prediction.

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Section: Introductionmentioning

confidence: 99%

Incremental prognostic value of stress phase entropy over standard PET myocardial perfusion imaging variables

Kuronuma

Miller

Kriekinge

et al. 2023

Eur J Nucl Med Mol Imaging

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“…15 Compared with other indicators of dyssynchrony, cardiac MR-FT has high reproducibility. 16 Furthermore, UREs have been applied to detect LVMD in patients with nonischemic heart failure, 17 Takotsubo syndrome, 18 and Ebstein's anomaly. 19 More importantly, UREs are useful for guiding cardiac resynchronization therapy.…”

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confidence: 99%

MR Uniformity Ratio Estimates to Evaluate Ventricular Mechanical Dyssynchrony and Prognosis After ST‐Segment Elevation Myocardial Infarction

Dong,

Wei,

Jin

et al. 2023

Magnetic Resonance Imaging

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BackgroundThe impact of left ventricular mechanical dyssynchrony (LVMD) on the long‐term prognosis of ST‐segment elevation myocardial infarction (STEMI) is unclear.HypothesisMR uniformity ratio estimates (URE) can detect LVMD and assess STEMI prognosis.Study TypeRetrospective analysis of a prospective multicenter registry (EARLY‐MYO trial, NCT 03768453).PopulationOverall, 450 patients (50 females) with first‐time STEMI were analyzed, as well as 40 participants without cardiovascular disease as controls.Field Strength/Sequence3.0‐T, balanced steady‐state free precession cine and late gadolinium enhancement imaging.AssessmentMRI data were acquired within 1 week of symptom onset. Major adverse cardiovascular events (MACEs), including cardiovascular death, nonfatal re‐infarction, hospitalization for heart failure, and stroke, were the primary clinical outcomes. LVMD was represented by circumferential URE (CURE) and radial URE (RURE) calculated using strain measurements. The patients were grouped according to clinical outcomes or URE values. Patients' clinical characteristics and MR indicators were compared.Statistical TestsThe Student's t‐test, Mann–Whitney U test, chi‐square test, Fisher's exact test, receiver operating characteristic curve analysis with area under the curve, Kaplan–Meier analysis, Cox regression, logistic regression, intraclass correlation coefficient, c‐index, and integrated discrimination improvement were used. P < 0.05 was considered statistically significant.ResultsCURE and RURE were significantly lower in patients with STEMI than in controls. The median follow‐up was 60.5 months. Patients with both lower CURE and RURE values experienced a significantly higher incidence of MACEs by 3.525‐fold. Both CURE and RURE were independent risk factors for MACEs. The addition of UREs improved diagnostic efficacy and risk stratification based on infarct size and left ventricular ejection fraction (LVEF). The indicators associated with LVMD included male sex, serum biomarkers (peak creatine phosphokinase and cardiac troponin I), infarct size, and LVEF.Data ConclusionCURE and RURE may be useful to evaluate long‐term prognosis after STEMI.Evidence Level4Technical EfficacyStage 2

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Beyond Ejection Fraction: Is There a Role for the Use of Mechanical Dispersion in Predicting Ventricular Arrhythmias?

Fernandes

Singh

2022

Journal of the American Society of Echocardiography

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The Prognostic Value of Left Ventricular Mechanical Dyssynchrony Derived from Cardiac MRI in Patients with Idiopathic Dilated Cardiomyopathy

Cited by 5 publications

References 32 publications

Incremental prognostic value of stress phase entropy over standard PET myocardial perfusion imaging variables

Incremental prognostic value of stress phase entropy over standard PET myocardial perfusion imaging variables

MR Uniformity Ratio Estimates to Evaluate Ventricular Mechanical Dyssynchrony and Prognosis After ST‐Segment Elevation Myocardial Infarction

Beyond Ejection Fraction: Is There a Role for the Use of Mechanical Dispersion in Predicting Ventricular Arrhythmias?

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