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Prediction of cardiac events using fully automated GLS and BNP titers in patients with known or suspected heart failure.

使用全自动GLS和BNP滴度预测已知或疑似心力衰竭患者的心脏事件。

  • 影响因子:0
  • DOI:10.1371/journal.pone.0234294
  • 作者列表:"Otani K","Higa Y","Kitano T","Nabeshima Y","Takeuchi M
  • 发表时间:2020-06-15
Abstract

BACKGROUND:Although global longitudinal strain (GLS) measurements provide useful predictive information, measurement variability is still a major concern. We sought to determine whether fully automated GLS measurements could predict future cardiac events in patients with known or suspected heart failure (HF). METHODS:GLS was measured using fully automated 2D speckle tracking analysis software (AutoStrain, TomTec) in 3,150 subjects who had undergone clinically indicated brain natriuretic peptide (BNP) assays and echocardiographic examinations. Among 1,514 patients in the derivation cohort, optimal cut-off values of BNP and GLS for cardiac death (CD) and major adverse cardiovascular events (MACEs) were determined using survival classification and regression tree (CART) analysis. The remaining 1,636 patients, comprising the validation cohort, were stratified into subgroups according to predefined cut-off values, and survival curves were compared. RESULTS:Survival CART analysis selected GLS with cut-off values of 6.2% and 14.0% for predicting CD. GLS of 6.9% and 13.9% and BNP of 83.2 pg/mL and 206.3 pg/mL were selected for predicting MACEs. For simplicity, we defined GLS of 7% and 14% and BNP of 100 pg/mL and 200 pg/mL as cut-off values. These cut-off values stratify high-risk patients in the validation cohort with known or suspected HF for both CD and MACEs. CONCLUSIONS:In addition to BNP, fully automated GLS measurements provide prognostic information for patients with known or suspected HF, and this approach facilitates clinical work flow.

摘要

背景: 尽管全球纵向应变 (GLS) 测量提供了有用的预测信息,但测量变异性仍然是一个主要问题。我们试图确定全自动GLS测量是否可以预测已知或疑似心力衰竭 (HF) 患者的未来心脏事件。 方法: 使用全自动二维斑点追踪分析软件 (autostrainse,TomTec) 对3,150名接受过临床指征脑钠肽 (BNP) 测定和超声心动图检查的受试者进行GLS测量。在推导队列的1,514例患者中,使用生存分类和回归树 (CART) 分析确定了BNP和GLS对于心脏死亡 (CD) 和主要不良心血管事件 (MACEs) 的最佳截止值。其余1,636例患者,包括验证队列,根据预定义的截止值分为亚组,并比较生存曲线。 结果: 生存CART分析选择具有6.2% 和14.0% 的截止值的GLS用于预测CD。选择6.9% 和13.9% 的GLS和83.2 pg/mL和206.3 pg/mL的BNP用于预测MACEs。为简单起见,我们将7% 和14% 的GLS和100 μ g/mL和200 μ g/mL的BNP定义为截止值。这些截止值对验证队列中CD和MACEs的已知或疑似HF的高风险患者进行分层。 结论: 除了BNP之外,全自动GLS测量为已知或疑似HF患者提供预后信息,并且这种方法促进了临床工作流程。

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关键词: 暂无
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心脏影像技术方向

心脏结构和心脏血流的可视化,用于诊断评估或通过内窥镜、放射性核素成像等技术来指导心脏手术。

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