Imaging and risk stratification in pulmonary arterial hypertension: time to include right ventricular assessment
Author(s)
Type
Journal Article
Abstract
Background: 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: 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: 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 (p < 0.01) and RVEF (p < 0.01) but not RA area were independent predictors of 1-year mortality. Conclusion: 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.
Date Issued
2022-03-25
Date Acceptance
2022-02-28
Citation
Frontiers in Cardiovascular Medicine, 2022, 9
ISSN
2297-055X
Publisher
Frontiers Media
Journal / Book Title
Frontiers in Cardiovascular Medicine
Volume
9
Copyright Statement
© 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. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/35402574
Subjects
cardiac magnetic resonance imaging (cMRI)
pulmonary arterial hypertension (PAH)
pulmonary hypertension
right atrial area
right ventricular (RV)
risk stratification
Publication Status
Published
Coverage Spatial
Switzerland
Article Number
ARTN 797561