The Application Value of Diffusion Weighted Magnetic Resonance Imaging and Late Gadolinium Enhancement in Evaluating the Prognosis of Ischemic Cardiomyopathy
Objective To investigate the application value of diffusion weighted magnetic resonance imaging(DWI)and late gadolinium enhancement(LGE-CMR)in evaluating the prognosis of ischemic cardiomyopathy(ICM).Methods 84 patients diagnosed with ICM in our hospital from June 2018 to June 2021 were selected as the study subjects.Divided into LGE positive group and LGE negative group based on the presence or absence of myocardial delayed enhancement in LGE-CMR.The LGE positive group was further divided into two subgroups according to the number of LGE positive segments＜6 and the number of cicatricardial segments＞6.The cardiac function parameter values and ADC values of patients in the LGE positive and negative groups were analyzed and compared,and the delayed reinforcement of patients in the two LGE positive subgroups were analyzed and compared,and the incidence of adverse cardiovascular events in the LGE positive and negative groups were analyzed and compared.The risk factors of adverse cardiovascular events were analyzed by multivariate Logistic regression analysis.ROC curve analysis was used to predict the AUC,optimal diagnostic cut-off point,sensitivity,specificity,and 95％CI of adverse cardiovascular events in ICM patients.Results The cardiac function parameters of patients in the LGE positive group were worse than those in the LGE negative group,and the ADC values of patients in the LGE positive group were lower than those in the LGE negative group.In the LGE positive group,the cardiac function parameters and ADC values of patients with scar myocardial segments＞6 were further reduced,(P＜0.05).Scar mass,scar mass percentage,gray area mass and gray area volume percentage in scar myocardia number＜6 subgroup were lower than those in scar myocardia number＞6 subgroup(P＜0.05).The probability of adverse cardiovascular events in LGE positive group was higher than that in LGE negative group(P＜0.05).Logistic regression analysis showed that LVEF,ADC and scar quality were risk factors for adverse cardiovascular events.The AUC of LVEF,ADC value and scar mass combined to predict adverse cardiovascular events in ICM patients was 0.875(95％CI:0.775-0.976,P＜0.001).Conclusion DWI and LGE-CMR can stratify the diagnosis and prognosis of ICM patients,which can provide reference for the formulation of treatment plan.
Magnetic ResonanceDiffusion Weighted ImagingLate Gadolinium EnhancementIschemic CardiomyopathyPrognosis
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