Cardiac magnetic resonance imaging as a prognostic biomarker in treatment-naïve pulmonary hypertension.
Publication/Presentation Date
2-1-2020
Abstract
PURPOSE: Targeted treatment for pulmonary arterial hypertension (PAH), diagnosed via right heart catheterization (RHC), has been shown to improve morbidity and mortality. Identifying characteristics that predict clinical worsening has been challenging. We sought to evaluate the role of cardiac Magnetic Resonance Imaging (CMR) as a predictor of clinical worsening in a cohort of treatment-naïve pulmonary hypertension (PH) patients.
METHODS: We performed a retrospective single center analysis of all adults with newly diagnosed treatment-naïve PH between January 1st 2013 and January 1st 2019. Patients with World Health Organization (WHO)-Group I PAH or WHO-Group II/III PH disease, who underwent both CMR (Signa Horizon 1.5 T, General Electric, Milwaukee, WI and Siemens Espree 1.5 T, Munich, Germany) and RHC testing prior to targeted PAH treatment, were included for analysis. Cox proportional hazards models were constructed.
RESULTS: A total of 38 patients, of which 12 (32 %) experienced the primary outcome of clinical worsening. were included in the final analysis, Patients with clinical worsening were significantly more likely to have RV dysfunction by CMR (including lower RV ejection fraction (HR 0.93, p = 0.007) and more RV dilation (HR 1.02, p = 0.005-0.021)) and RHC (including worse pulmonary vascular resistance (HR 1.32, p < 0.001)), even after adjustment for disease severity. Both CMR and RHC measures of RV dysfunction were found to be equally effective in predicting clinical worsening, regardless of PH etiology.
CONCLUSIONS: In treatment-naïve PH patients, including those with WHO-Group II/III disease, both CMR and RHC measures independently and significantly predicted clinical worsening, even after adjustment for disease severity.
Volume
123
First Page
108784
Last Page
108784
ISSN
1872-7727
Published In/Presented At
Jose, A., Kher, A., O'Donnell, R. E., & Elwing, J. M. (2020). Cardiac magnetic resonance imaging as a prognostic biomarker in treatment-naïve pulmonary hypertension. European journal of radiology, 123, 108784. https://doi.org/10.1016/j.ejrad.2019.108784
Disciplines
Medicine and Health Sciences
PubMedID
31862635
Department(s)
Department of Medicine, Cardiology Division, Department of Medicine Fellows and Residents, Fellows and Residents
Document Type
Article