RESUMO
Objective: To explore the value of cardiac magnetic resonance imaging (CMR) in the risk stratification of hypertrophic cardiomyopathy (HCM). Methods: HCM patients who underwent CMR examination in Fuwai Hospital between March 2012 and May 2013 were retrospectively enrolled. Baseline clinical and CMR data were collected and patient follow-up was performed using telephone contact and medical record. The primary composite endpoint was sudden cardiac death (SCD) or and equivalent event. The secondary composite endpoint was all-cause death and heart transplant. Patients were divided into SCD and non-SCD groups. Cox regression was used to explore risk factors of adverse events. Receiver operating characteristic (ROC) curve analysis was used to assess the performance and the optimal cut-off of late gadolinium enhancement percentage (LGE%) for the prediction of endpoints. Kaplan-Meier and log-rank tests were used to compare survival differences between groups. Results: A total of 442 patients were enrolled. Mean age was (48.5±12.4) years and 143(32.4%) were female. At (7.6±2.5) years of follow-up, 30 (6.8%) patients met the primary endpoint including 23 SCD and 7 SCD equivalent events, and 36 (8.1%) patients met the secondary endpoint including 33 all-cause death and 3 heart transplant. In multivariate Cox regression, syncope(HR=4.531, 95%CI 2.033-10.099, P<0.001), LGE% (HR=1.075, 95%CI 1.032-1.120, P=0.001) and left ventricular ejection fraction (LVEF) (HR=0.956, 95%CI 0.923-0.991, P=0.013) were independent risk factors for primary endpoint; Age (HR=1.032, 95%CI 1.001-1.064, P=0.046), atrial fibrillation (HR=2.977, 95%CI 1.446-6.131, P=0.003),LGE% (HR=1.075, 95%CI 1.035-1.116, P<0.001) and LVEF (HR=0.968, 95%CI 0.937-1.000, P=0.047) were independent risk factors for secondary endpoint. ROC curve showed the optimal LGE% cut-offs were 5.1% and 5.8% for the prediction of primary and secondary endpoint, respectively. Patients were further divided into LGE%=0, 0Assuntos
Cardiomiopatia Hipertrófica
, Meios de Contraste
, Humanos
, Feminino
, Adulto
, Pessoa de Meia-Idade
, Masculino
, Estudos Retrospectivos
, Volume Sistólico
, Gadolínio
, Função Ventricular Esquerda
, Imageamento por Ressonância Magnética
, Cardiomiopatia Hipertrófica/diagnóstico por imagem
, Morte Súbita Cardíaca
, Medição de Risco
Assuntos
Falso Aneurisma , Ventrículos do Coração , Imageamento por Ressonância Magnética , Humanos , Imageamento por Ressonância Magnética/métodos , Falso Aneurisma/diagnóstico , Ventrículos do Coração/diagnóstico por imagem , Masculino , Aneurisma Cardíaco/diagnóstico , Aneurisma Cardíaco/diagnóstico por imagemRESUMO
By means of Transmission Electron Microscope (TEM), it was observed that Sijunzi Decoction (SD) affected the liver and ultrastructure of cerebral cortex in aging mice. The results showed that SD could improve the liver cells and the ultrastructure of cerebral cortex in aging mice, nourish the Viscera with Qi and blood by replenishing Spleen and Qi, adjust the Deficienoy of Viscera and promote the health of body and longevity.