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Atrioventricular plane displacement and regional function to predict outcome in pulmonary arterial hypertension.
Lindholm, Anthony; Kjellström, Barbro; Seemann, Felicia; Carlsson, Marcus; Hesselstrand, Roger; Rådegran, Göran; Arheden, Håkan; Ostenfeld, Ellen.
Afiliación
  • Lindholm A; Department of Clinical Sciences Lund, Clinical Physiology and Skåne University Hospital, Lund University, 221 85, Lund, Sweden.
  • Kjellström B; Department of Clinical Sciences Lund, Clinical Physiology and Skåne University Hospital, Lund University, 221 85, Lund, Sweden.
  • Seemann F; Cardiology Unit, Department of Medicine, Karolinska Institute, Stockholm, Sweden.
  • Carlsson M; Department of Clinical Sciences Lund, Clinical Physiology and Skåne University Hospital, Lund University, 221 85, Lund, Sweden.
  • Hesselstrand R; Department of Biomedical Engineering, Faculty of Engineering, Lund University, Lund, Sweden.
  • Rådegran G; Department of Clinical Sciences Lund, Clinical Physiology and Skåne University Hospital, Lund University, 221 85, Lund, Sweden.
  • Arheden H; Department of Clinical Sciences Lund, Rheumatology, and the Clinic for Rheumatology, Skåne University Hospital, Lund University, Lund, Sweden.
  • Ostenfeld E; Department of Clinical Sciences Lund, Cardiology, and the Section for Heart Failure and Valvular Disease, Skåne University Hospital, Lund University, Lund, Sweden.
Int J Cardiovasc Imaging ; 38(10): 2235-2248, 2022 Oct.
Article en En | MEDLINE | ID: mdl-37726454
To investigate if left and right atrioventricular plane displacement (AVPD) or regional contributions to SV are prognostic for outcome in patients with pulmonary arterial hypertension (PAH). Seventy-one patients with PAH and 20 sex- and age-matched healthy controls underwent CMR. Myocardial borders and RV insertion points were defined at end diastole and end systole in cine short-axis stacks to compute biventricular volumes, lateral (SVlat%) and septal (SVsept%) contribution to stroke volume. Eight atrioventricular points were defined at end diastole and end systole in 2-, 3- and 4-chamber cine long-axis views for computation of AVPD and longitudinal contribution to stroke volume (SVlong%). Cut-off values for survival analysis were defined as two standard deviations above or below the mean of the controls. Outcome was defined as death or lung transplantation. Median follow-up time was 3.6 [IQR 3.7] years. Patients were 57 ± 19 years (65% women) and controls 58 ± 15 years (70% women). Biventricular AVPD, SVlong% and ejection fraction (EF) were lower and SVlat% was higher, while SVsept% was lower in PAH compared with controls. In PAH, transplantation-free survival was lower below cut-off for LV-AVPD (hazard ratio [HR] = 2.1, 95%CI 1.2-3.9, p = 0.02) and RV-AVPD (HR = 9.8, 95%CI 4.6-21.1, p = 0.005). In Cox regression analysis, lower LV-AVPD and RV-AVPD inferred lower transplantation-free survival (LV: HR = 1.16, p = 0.007; RV: HR = 1.11, p = 0.01; per mm decrease). LV-SVlong%, RV-SVlong%, LV-SVlat%, RV-SVlat%, SVsept% and LV- and RVEF did not affect outcome. Low left and right AVPD were associated with outcome in PAH, but regional contributions to stroke volume and EF were not.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hipertensión Arterial Pulmonar Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Int J Cardiovasc Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2022 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hipertensión Arterial Pulmonar Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: Int J Cardiovasc Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2022 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos