Papers

Peer-reviewed International journal
Mar 1, 2020

Right ventricular dimension index by cardiac magnetic resonance for prognostication in connective tissue diseases and pulmonary hypertension.

Rheumatology (Oxford, England)
  • Nobuya Abe
  • Masaru Kato
  • Michihito Kono
  • Yuichiro Fujieda
  • Hiroshi Ohira
  • Ichizo Tsujino
  • Noriko Oyama-Manabe
  • Kenji Oku
  • Toshiyuki Bohgaki
  • Shinsuke Yasuda
  • Tatsuya Atsumi
  • Display all

Volume
59
Number
3
First page
622
Last page
633
Language
English
Publishing type
Research paper (scientific journal)
DOI
10.1093/rheumatology/kez336

OBJECTIVES: Pulmonary hypertension (PH) in patients with CTD is a heterogeneous condition affected by left heart disease, chronic lung disease and thromboembolism as well as pulmonary vascular disease. Recent studies using cardiac magnetic resonance (CMR) have shown that right ventricular dysfunction is predictive for mortality in patients with PH, but limited to pulmonary arterial hypertension. This study aimed to analyse prognostic factors in PH-CTD. METHODS: This retrospective analysis comprised 84 CTD patients, including SSc, who underwent both CMR and right heart catheterization from 2008 to 2018. Demographics, laboratory findings, and haemodynamic and morphological parameters were extracted. The prognostic value of each parameter was evaluated by multivariate analysis using covariables derived from propensity score to control confounding factors. RESULTS: Of 84 patients, 65 had right heart catheterization-confirmed PH (54 pulmonary arterial hypertension, 11 non-pulmonary arterial hypertension). Nine out of these PH patients died during a median follow-up period of 25 months. In 65 patients with PH, right ventricular end-diastolic dimension index (RVEDDI) evaluated by CMR was independently associated with mortality (hazard ratio 1.24; 95% CI: 1.08-1.46; P = 0.003). In a receiver operating characteristic analysis, RVEDDI highly predicted mortality, with area under the curve of 0.87. The 0.5-2-year follow-up data revealed that RVEDDI in both survivors and non-survivors did not significantly change over the clinical course, leading to the possibility that an early determination of RVEDDI could predict the prognosis. CONCLUSION: RVEDDI simply evaluated by CMR could serve as a significant predictor of mortality in PH-CTD. A further validation cohort study is needed to confirm its usability.

Link information
DOI
https://doi.org/10.1093/rheumatology/kez336
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31424519
ID information
  • DOI : 10.1093/rheumatology/kez336
  • ISSN : 1462-0324
  • Pubmed ID : 31424519

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