Imaging and Risk Stratification in Pulmonary Arterial Hypertension: Time to Include Right Ventricular Assessment.
cardiac magnetic resonance imaging (cMRI)
pulmonary arterial hypertension (PAH)
pulmonary hypertension
right atrial area
right ventricular (RV)
risk stratification
Journal
Frontiers in cardiovascular medicine
ISSN: 2297-055X
Titre abrégé: Front Cardiovasc Med
Pays: Switzerland
ID NLM: 101653388
Informations de publication
Date de publication:
2022
2022
Historique:
received:
18
10
2021
accepted:
28
02
2022
entrez:
11
4
2022
pubmed:
12
4
2022
medline:
12
4
2022
Statut:
epublish
Résumé
Current European Society of Cardiology and European Respiratory Society guidelines recommend regular risk stratification with an aim of treating patients with pulmonary arterial hypertension (PAH) to improve or maintain low-risk status (<5% 1-year mortality). Consecutive patients with PAH who underwent cardiac magnetic resonance imaging (cMRI) were identified from the Assessing the Spectrum of Pulmonary hypertension Identified at a Referral centre (ASPIRE) registry. Kaplan-Meier survival curves, locally weighted scatterplot smoothing regression and multi-variable logistic regression analysis were performed. In 311 consecutive, treatment-naïve patients with PAH undergoing cMRI including 121 undergoing follow-up cMRI, measures of right ventricular (RV) function including right ventricular ejection fraction (RVEF) and RV end systolic volume and right atrial (RA) area had prognostic value. However, only RV metrics were able to identify a low-risk status. Age ( This study highlights the need for guidelines to include measures of RV function rather than RA area alone to aid the risk stratification of patients with PAH.
Sections du résumé
Background
UNASSIGNED
Current European Society of Cardiology and European Respiratory Society guidelines recommend regular risk stratification with an aim of treating patients with pulmonary arterial hypertension (PAH) to improve or maintain low-risk status (<5% 1-year mortality).
Methods
UNASSIGNED
Consecutive patients with PAH who underwent cardiac magnetic resonance imaging (cMRI) were identified from the Assessing the Spectrum of Pulmonary hypertension Identified at a Referral centre (ASPIRE) registry. Kaplan-Meier survival curves, locally weighted scatterplot smoothing regression and multi-variable logistic regression analysis were performed.
Results
UNASSIGNED
In 311 consecutive, treatment-naïve patients with PAH undergoing cMRI including 121 undergoing follow-up cMRI, measures of right ventricular (RV) function including right ventricular ejection fraction (RVEF) and RV end systolic volume and right atrial (RA) area had prognostic value. However, only RV metrics were able to identify a low-risk status. Age (
Conclusion
UNASSIGNED
This study highlights the need for guidelines to include measures of RV function rather than RA area alone to aid the risk stratification of patients with PAH.
Identifiants
pubmed: 35402574
doi: 10.3389/fcvm.2022.797561
pmc: PMC8989834
doi:
Types de publication
Journal Article
Langues
eng
Pagination
797561Subventions
Organisme : Wellcome Trust
ID : 205188/Z/16/Z
Pays : United Kingdom
Organisme : British Heart Foundation
ID : FS/18/13/33281
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/M008894/1
Pays : United Kingdom
Organisme : British Heart Foundation
ID : SP/14/6/31350
Pays : United Kingdom
Informations de copyright
Copyright © 2022 Alandejani, Hameed, Tubman, Alabed, Shahin, Lewis, Dwivedi, Mahmood, Middleton, Watson, Alkhanfar, Johns, Rajaram, Garg, Condliffe, Elliot, Thompson, Rothman, Charalampopoulos, Lawrie, Wild, Swift and Kiely.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Int J Cardiovasc Imaging. 2016 Jul;32(7):1121-30
pubmed: 27076226
Eur Respir J. 2020 Sep 24;56(3):
pubmed: 32430422
Thorax. 2021 Oct;76(10):1032-1035
pubmed: 33632769
BMJ Open. 2020 Sep 22;10(9):e031316
pubmed: 32963060
JACC Cardiovasc Imaging. 2022 Feb;15(2):240-253
pubmed: 34801462
Eur Respir J. 2012 Apr;39(4):945-55
pubmed: 21885399
J Am Coll Cardiol. 2011 Dec 6;58(24):2511-9
pubmed: 22133851
Am J Respir Crit Care Med. 2020 Feb 15;201(4):458-468
pubmed: 31647310
JACC Cardiovasc Imaging. 2021 May;14(5):931-942
pubmed: 33008758
JACC Cardiovasc Imaging. 2021 Jun;14(6):1271-1272
pubmed: 33221232
Eur Respir J. 2015 Oct;46(4):903-75
pubmed: 26318161