Rechercher
image du produit
American Heart Journal

S'abonner

Cardiac imaging and biomarkers for assessing myocardial fibrosis in children with hypertrophic cardiomyopathy - 13/09/23

Doi : 10.1016/j.ahj.2023.06.005 
Sonya Kirmani, MD a, Pamela K. Woodard, MD b, Ling Shi, PhD c, Taye H. Hamza, PhD d, Charles E. Canter, MD e, Steven D. Colan, MD f, Elfriede Pahl, MD g, Jeffrey A. Towbin, MD h, Steven A. Webber, MBChB i, Joseph W. Rossano, MD, MS j, Melanie D. Everitt, MD k, Kimberly M. Molina, MD l, Paul F. Kantor, MBBCh, MSc m, John L. Jefferies, MD n, Brian Feingold, MD, MS o, Linda J. Addonizio, MD p, Stephanie M. Ware, MDPhD q, Wendy K. Chung, MDPhD p, Jean A. Ballweg, MD r, Teresa M. Lee, MD p, Neha Bansal, MD s, Hiedy Razoky, MBA t, Jason Czachor, MS t, Fatima I. Lunze, MD, ScD, PhD f, u, Edward Marcus, MSc f, Paul Commean, BEE b, James D. Wilkinson, MD, MPH i, Steven E. Lipshultz, MD v, ⁎
a Department of Pediatrics, University of Wisconsin-Madison, Madison, WI 
b Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 
c New England Research Institute, Watertown, MA 
d HealthCore, Watertown, MA 
e Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 
f Department of Cardiology, Boston Children's Hospital, Boston, MA 
g Department of Pediatrics, Northwestern Feinberg School of Medicine, Chicago, IL 
h Heart Institute, Le Bonheur Children's Hospital, Memphis, TN 
i Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN 
j Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 
k Department of Pediatrics, Children's Hospital of Colorado, Aurora, CO 
l Department of Pediatrics, Primary Children's Hospital, Salt Lake City, UT 
m Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA 
n Department of Medicine, University of Tennessee, Memphis, TN 
o Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA 
p Department of Pediatrics, Columbia University Irving Medical Center, New York, NY 
q Department of Pediatrics and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 
r Department of Pediatrics, Helen DeVos Children's Hospital, Grand Rapids, MI 
s Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY 
t Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI 
u German Heart Center Berlin, Charité Medical School, Berlin, Germany 
v Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY 

⁎Reprint requests: Steven E. Lipshultz, MD, FAAP, FAHA, Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Clinical and Translational Research Center, 875 Ellicott Street, Suite 5018, Buffalo, New York 14203.Department of PediatricsUniversity at Buffalo Jacobs School of Medicine and Biomedical Sciences, Clinical and Translational Research Center875 Ellicott Street, Suite 5018, BuffaloNew York14203

Résumé

Background

Myocardial fibrosis, as diagnosed on cardiac magnetic resonance imaging (cMRI) by late gadolinium enhancement (LGE), is associated with adverse outcomes in adults with hypertrophic cardiomyopathy (HCM), but its prevalence and magnitude in children with HCM have not been established. We investigated: (1) the prevalence and extent of myocardial fibrosis as detected by LGE cMRI; (2) the agreement between echocardiographic and cMRI measurements of cardiac structure; and (3) whether serum concentrations of N-terminal pro hormone B-type natriuretic peptide (NT-proBNP) and cardiac troponin-T are associated with cMRI measurements.

Methods

A cross-section of children with HCM from 9 tertiary-care pediatric heart centers in the U.S. and Canada were enrolled in this prospective NHLBI study of cardiac biomarkers in pediatric cardiomyopathy (ClinicalTrials.gov Identifier: NCT01873976). The median age of the 67 participants was 13.8 years (range 1-18 years). Core laboratories analyzed echocardiographic and cMRI measurements, and serum biomarker concentrations.

Results

In 52 children with non-obstructive HCM undergoing cMRI, overall low levels of myocardial fibrosis with LGE >2% of left ventricular (LV) mass were detected in 37 (71%) (median %LGE, 9.0%; IQR: 6.0%, 13.0%; range, 0% to 57%). Echocardiographic and cMRI measurements of LV dimensions, LV mass, and interventricular septal thickness showed good agreement using the Bland-Altman method. NT-proBNP concentrations were strongly and positively associated with LV mass and interventricular septal thickness (P < .001), but not LGE.

Conclusions

Low levels of myocardial fibrosis are common in pediatric patients with HCM seen at referral centers. Longitudinal studies of myocardial fibrosis and serum biomarkers are warranted to determine their predictive value for adverse outcomes in pediatric patients with HCM.

Le texte complet de cet article est disponible en PDF.

Abbreviations : BNP, BSA, CLIA, cMRI, HF, HCM, IQR, ICD, LGE, LV, LVEDV, LVESV, NHLBI, NT-proBNP, SCD


Plan


© 2023  Elsevier Inc. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

    •

  • Contenu

    •

Vol 264

P. 153-162 - octobre 2023 Retour au numéro
Article précédent Article précédent
  • Association between racial residential segregation and Black-White disparities in cardiovascular disease mortality
  • Kriyana P. Reddy, Lauren A. Eberly, Howard M. Julien, Jay Giri, Alexander C. Fanaroff, Peter W. Groeneveld, Sameed Ahmed M. Khatana, Ashwin S. Nathan
| Article suivant Article suivant
  • Geographic distribution of United States clinical trial sites utilized for guideline changing studies of cholesterol management
  • Marwah E. Alnewais, Lauren Adams, Abdulaziz S. Alfehaid, Shayma Alzaidi, Erin R. Weeda

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.

Déjà abonné à cette revue ?

Accès rapides

Mon compte

Aide & support

Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.

Tout le contenu de ce site: Copyright © 2024 Elsevier, ses concédants de licence et ses contributeurs. Tout les droits sont réservés, y compris ceux relatifs à l'exploration de textes et de données, a la formation en IA et aux technologies similaires. Pour tout contenu en libre accès, les conditions de licence Creative Commons s'appliquent.