Myocardial regional interstitial fibrosis, measured by extracellular volume fraction, was positively associated with left intra-ventricular dyssynchrony, with a 1% increase in ECV increasing contraction time by 3.77 ms.
Cross-Sectional (n=138)
No
Is myocardial regional interstitial fibrosis associated with left intra-ventricular dyssynchrony in patients with heart failure?
Myocardial regional interstitial fibrosis is closely related to left intra-ventricular dyssynchrony irrespective of global LV function, providing a potential pathophysiological mechanism for dyssynchrony in heart failure.
Effect estimate: Coefficient 3.77 (95% CI 2.72-4.81)
p-value: p=<0.001
Left ventricular (LV) dyssynchrony is associated with poor prognosis in patients with heart failure (HF). The mechanisms leading to LV dyssynchrony are not fully elucidated. This study evaluates whether myocardium regional variation in interstitial fibrosis is associated with LV dyssynchrony. Forty-two patients with systolic heart failure (SHF), 76 patients with heart failure with preserved ejection fraction (HFpEF) and 20 patients without HF received cardiovascular magnetic resonance imaging (MRI) study. LV was divided into 18 segments by short-axis view. In each segment, regional extracellular volume fraction (ECV) and the time taken to reach minimum regional volume (Tmv) were derived. Intra-LV dyssynchrony were represented by maximum difference (Dysynₘax) and standard deviation (Dysynₛd) of all Tmv. The results showed that among the covariates, only age (1. 87, 95% CI: 0. 61-3. 13, p = 0. 004) and ECV (3. 77, 95% CI: 2. 72-4. 81, p < 0. 001) were positively associated with Tmv. The results remained robust in certain subgroups. In conclusion, we demonstrated that LV myocardium regional variation in interstitial fibrosis is closely related to LV intra-ventricular dyssynchrony irrespective of the LV global function. These data might help explain the pathophysiology of LV dyssynchrony and it's underlying mechanisms leading to poor prognosis.
Lin et al. (Fri,) conducted a cross-sectional in Heart Failure (n=138). Cardiovascular Magnetic Resonance Imaging (T1 mapping) was evaluated on Association between regional extracellular volume fraction (ECV) and time taken to reach minimum regional volume (Tmv) (Coefficient 3.77, 95% CI 2.72-4.81, p=<0.001). Myocardial regional interstitial fibrosis, measured by extracellular volume fraction, was positively associated with left intra-ventricular dyssynchrony, with a 1% increase in ECV increasing contraction time by 3.77 ms.
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