Prognostic value of cardiovascular magnetic resonance imaging measurements corrected for age and sex in idiopathic pulmonary arterial hypertension

• Published in: Circulation. Cardiovascular imaging Vol. 7; no. 1; pp. 100 - 106
• Main Authors: Swift, Andrew J, Rajaram, Smitha, Campbell, Michael J, Hurdman, Judith, Thomas, Steve, Capener, Dave, Elliot, Charlie, Condliffe, Robin, Wild, Jim M, Kiely, David G
• Format: Journal Article
• Language: English
• Published: United States 01.01.2014
• Subjects: Adult; Age Factors; Aged; Body Surface Area; Chi-Square Distribution; Familial Primary Pulmonary Hypertension; Female; Humans; Hypertension, Pulmonary - diagnosis; Hypertension, Pulmonary - mortality; Hypertension, Pulmonary - physiopathology; Kaplan-Meier Estimate; Magnetic Resonance Imaging, Cine; Male; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Retrospective Studies; Sex Factors; Stroke Volume; Time Factors; Ventricular Dysfunction, Right - diagnosis; Ventricular Dysfunction, Right - mortality; Ventricular Dysfunction, Right - physiopathology; Ventricular Function, Left; Ventricular Function, Right; hypertension, pulmonary; magnetic resonance imaging; heart ventricles; prognosis
• ISSN: 1941-9651; 1942-0080
• DOI: 10.1161/circimaging.113.000338

There are limited data on the prognostic value of cardiovascular magnetic resonance measurements in idiopathic pulmonary arterial hypertension, with no studies investigating the impact of correction of cardiovascular magnetic resonance indices for age and sex on prognostic value. Consecutive patients with idiopathic pulmonary arterial hypertension underwent cardiovascular magnetic resonance imaging at 1.5T. Steady-state free precession cardiac volumes and mass measurements were corrected for age, sex, and body surface area according to reference data and prognostic significance assessed. A total of 80 patients with idiopathic pulmonary arterial hypertension were identified, and 23 patients died during the mean follow-up of 32±14 months. Corrected for age, sex, and body surface area, right ventricular end-systolic volume (P=0.004) strongly predicted mortality, independent of World Health Organization functional class, mean right atrial pressure, cardiac index, and mixed venous oxygen saturations. Consideration should be given to correcting cardiovascular magnetic resonance measures for age, sex, and body surface area, particularly given the changing demographics of patients with idiopathic pulmonary arterial hypertension. Corrected right ventricular end-systolic volume is a strong prognostic marker in idiopathic pulmonary arterial hypertension, independent of invasively derived measurements, mean right atrial pressure cardiac index, and mixed venous oxygen saturations.