| Title: |
Identification of Cardiac Magnetic Resonance Imaging Thresholds for Risk Stratification in Pulmonary Arterial Hypertension |
| Authors: |
Lewis, Robert A.; Johns, Christopher S.; Cogliano, Marcella; Capener, David; Tubman, Euan; Elliot, Charlie A.; Charalampopoulos, Athanasios; Sabroe, Ian; Thompson, A. A. Roger; Billings, Catherine G.; Hamilton, Neil; Baster, Kathleen; Laud, Peter J.; Hickey, Peter M.; Middleton, Jennifer; Armstrong, Iain J.; Hurdman, Judith A.; Lawrie, Allan; Rothman, Alexander M. K.; Wild, Jim M.; Condliffe, Robin; Swift, Andrew J.; Kiely, David G. |
| Source: |
American Journal of Respiratory and Critical Care Medicine ; volume 201, issue 4, page 458-468 ; ISSN 1073-449X 1535-4970 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2020 |
| Description: |
Rationale Pulmonary arterial hypertension (PAH) is a life-shortening condition. The European Society of Cardiology and European Respiratory Society and the REVEAL (North American Registry to Evaluate Early and Long-Term PAH Disease Management) risk score calculator (REVEAL 2.0) identify thresholds to predict 1-year mortality. Objectives This study evaluates whether cardiac magnetic resonance imaging (MRI) thresholds can be identified and used to aid risk stratification and facilitate decision-making. Methods Consecutive patients with PAH (n = 438) undergoing cardiac MRI were identified from the ASPIRE (Assessing the Spectrum of Pulmonary Hypertension Identified at a Referral Center) MRI database. Thresholds were identified from a discovery cohort and evaluated in a test cohort. Measurements and Main Results A percentage-predicted right ventricular end-systolic volume index threshold of 227% or a left ventricular end-diastolic volume index of 58 ml/m2 identified patients at low (10%) risk of 1-year mortality. These metrics respectively identified 63% and 34% of patients as low risk. Right ventricular ejection fraction >54%, 37–54%, and |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1164/rccm.201909-1771oc |
| Availability: |
https://doi.org/10.1164/rccm.201909-1771oc; https://academic.oup.com/ajrccm/article-pdf/201/4/458/67179003/ajrccm_201_4_458.pdf |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.AF2D70EC |
| Database: |
BASE |