TY - JOUR
T1 - Changes in right ventricular function measured by cardiac magnetic resonance imaging in patients receiving pulmonary arterial hypertension-targeted therapy the EURO-MR study
AU - Peacock, Andrew J.
AU - Crawley, Stephen
AU - McLure, Lindsey
AU - Blyth, Kevin
AU - Vizza, Carmine Dario
AU - Poscia, Roberto
AU - Francone, Marco
AU - Iacucci, Ilaria
AU - Olschewski, Horst
AU - Kovacs, Gabor
AU - Vonk Noordegraaf, Anton
AU - Marcus, J. Tim
AU - Van De Veerdonk, Marielle C.
AU - Oosterveer, Frank P.T.
PY - 2014/1
Y1 - 2014/1
N2 - Background-Most measures that predict survival in pulmonary hypertension (PH) relate directly to, or correlate with, right ventricular (RV) function. Direct assessment of RV function using noninvasive techniques such as cardiac MRI may therefore be an appropriate way of determining response to therapy and monitoring disease progression in PH. Methods and Results-In this pan-European study, 91 patients with PH (mean pulmonary arterial pressure 46±15 mm Hg) underwent clinical and cardiac MRI assessments at baseline and after 12 months of disease-targeted therapy (predominantly endothelin receptor antagonists [47.3%] or phosphodiesterase type-5 inhibitors [25.3%]). At month 12, functional class had improved in 21 patients, was unchanged in 63 patients, and had deteriorated in 7 patients. Significant improvements were achieved in RV and left ventricular ejection fraction ( >0.001 and P=0.0007, respectively), RV stroke volume index ( >0.0001), and left ventricular end-diastolic volume index (P=0.0015). Increases in 6-minute walk distance were significant ( >0.0001) and correlated with change in RV ejection fraction and left ventricular end-diastolic volume, although correlation coefficients were low (r=0.28, P=0.01 and r=0.26, P=0.02, respectively). Conclusions-On-treatment changes in cardiac MRI-derived variables from left and right sides of the heart reflected changes in functional class and survival in patients with PH. Direct measurement of RV function using cardiac MRI can fully assess potential benefits of treatment in PH.
AB - Background-Most measures that predict survival in pulmonary hypertension (PH) relate directly to, or correlate with, right ventricular (RV) function. Direct assessment of RV function using noninvasive techniques such as cardiac MRI may therefore be an appropriate way of determining response to therapy and monitoring disease progression in PH. Methods and Results-In this pan-European study, 91 patients with PH (mean pulmonary arterial pressure 46±15 mm Hg) underwent clinical and cardiac MRI assessments at baseline and after 12 months of disease-targeted therapy (predominantly endothelin receptor antagonists [47.3%] or phosphodiesterase type-5 inhibitors [25.3%]). At month 12, functional class had improved in 21 patients, was unchanged in 63 patients, and had deteriorated in 7 patients. Significant improvements were achieved in RV and left ventricular ejection fraction ( >0.001 and P=0.0007, respectively), RV stroke volume index ( >0.0001), and left ventricular end-diastolic volume index (P=0.0015). Increases in 6-minute walk distance were significant ( >0.0001) and correlated with change in RV ejection fraction and left ventricular end-diastolic volume, although correlation coefficients were low (r=0.28, P=0.01 and r=0.26, P=0.02, respectively). Conclusions-On-treatment changes in cardiac MRI-derived variables from left and right sides of the heart reflected changes in functional class and survival in patients with PH. Direct measurement of RV function using cardiac MRI can fully assess potential benefits of treatment in PH.
KW - Hypertension
KW - Magnetic resonance imaging
KW - Pulmonary
KW - Right ventricle
UR - http://www.scopus.com/inward/record.url?scp=84897020076&partnerID=8YFLogxK
U2 - https://doi.org/10.1161/CIRCIMAGING.113.000629
DO - https://doi.org/10.1161/CIRCIMAGING.113.000629
M3 - Article
C2 - 24173272
SN - 1941-9651
VL - 7
SP - 107
EP - 114
JO - Circulation: Cardiovascular Imaging
JF - Circulation: Cardiovascular Imaging
IS - 1
ER -