Cardiac magnetic resonance-derived right ventricular outflow tract systolic flow acceleration: a novel index of right ventricular function and prognosis in patients with pulmonary arterial hypertension

Kang, Kyungkeun; Chang, Hyuk Jae; Yoo, Yeon Pyo; Yoon, Hyeon Soo; Kim, Young Jin; Choi, Byoung Wook; Shim, Chi Young; Ha, Jong‐Won; Chung, Namsik

doi:10.1007/s10554-013-0262-2

Cited by 7 publications

(2 citation statements)

References 30 publications

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“…( 30 ), 2020 ∗ U.S. RCS 2013–2019 38 68 51 ± 17 45 ± 15 18 20 20 (11–35) 4 (11) Kang et al. ( 19 ), 2013 South Korea PCS 2009–2010 30 74 45 ± 13 51 ± 23 19 2 7 2 17 ± 7 1 (3) 6 (20) Knight et al. ( 20 ), 2015 U.K. CC 2012–2013 40 75 50 ± 5 46 ± 13 12 20 8 20 ± 8 1 (3) 8 (20) Leng et al.…”

Section: Resultsmentioning

confidence: 99%

“…Our comprehensive search identified a total of 22 studies that were included in the meta-analysis ( 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ). The details of the literature search are presented in the supplemental materials, including a Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow diagram ( Supplemental Appendix 3 ).…”

Section: Resultsmentioning

confidence: 99%

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Cardiac-MRI Predicts Clinical Worsening and Mortality in Pulmonary Arterial Hypertension

Alabed¹,

Shahin²,

Garg

et al. 2021

JACC: Cardiovascular Imaging

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Objectives This meta-analysis evaluates assessment of pulmonary arterial hypertension (PAH), with a focus on clinical worsening and mortality. Background Cardiac magnetic resonance (CMR) has prognostic value in the assessment of patients with PAH. However, there are limited data on the prediction of clinical worsening, an important composite endpoint used in PAH therapy trials. Methods The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Web of Science databases were searched in May 2020. All CMR studies assessing clinical worsening and the prognosis of patients with PAH were included. Pooled hazard ratios of univariate regression analyses for CMR measurements, for prediction of clinical worsening and mortality, were calculated. Results Twenty-two studies with 1,938 participants were included in the meta-analysis. There were 18 clinical worsening events and 8 deaths per 100 patient-years. The pooled hazard ratios show that every 1% decrease in right ventricular (RV) ejection fraction is associated with a 4.9% increase in the risk of clinical worsening over 22 months of follow-up and a 2.2% increase in the risk of death over 54 months. For every 1 ml/m 2 increase in RV end-systolic volume index or RV end-diastolic volume index, the risk of clinical worsening increases by 1.3% and 0.7%, respectively, and the risk of mortality increases by 0.9% and 1%. Every 1 ml/m 2 decrease in left ventricular end-systolic volume index or left ventricular end-diastolic volume index increased the risk of death by 2.1% and 2.3%. Left ventricular parameters were not associated with clinical worsening. Conclusions This review confirms CMR as a powerful prognostic marker in PAH in a large cohort of patients. In addition to confirming previous observations that RV function and RV and left ventricular volumes predict mortality, RV function and volumes also predict clinical worsening. This study provides a strong rationale for considering CMR as a clinically relevant endpoint for trials of PAH therapies.

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