| Title: |
Cardiovascular magnetic resonance predicts all-cause mortality in pulmonary hypertension associated with heart failure with preserved ejection fraction |
| Authors: |
Garg, P.; Lewis, R.A.; Johns, C.S.; Swift, A.J.; Capener, D.; Rajaram, S.; Thompson, A.A.R.; Condliffe, R.; Elliot, C.A.; Charalampopoulos, A.; Hameed, A.G.; Rothman, A.; Wild, J.M.; Kiely, D.G. |
| Publisher Information: |
Springer Nature |
| Publication Year: |
2021 |
| Collection: |
White Rose Research Online (Universities of Leeds, Sheffield & York) |
| Description: |
This study aimed to determine the prognostic value of cardiovascular magnetic resonance (CMR) in patients with heart failure with preserved ejection fraction and associated pulmonary hypertension (pulmonary hypertension-HFpEF). Patients with pulmonary hypertension-HFpEF were recruited from the ASPIRE registry and underwent right heart catheterisation (RHC) and CMR. On RHC, the inclusion criteria was a mean pulmonary artery pressure (MPAP) ≥ 25 mmHg and pulmonary arterial wedge pressure > 15 mmHg and, on CMR, a left atrial volume > 41 ml/m2 with left ventricular ejection fraction > 50%. Cox regression was performed to evaluate CMR against all-cause mortality. In this study, 116 patients with pulmonary hypertension-HFpEF were identified. Over a mean follow-up period of 3 ± 2 years, 61 patients with pulmonary hypertension-HFpEF died (53%). In univariate regression, 11 variables demonstrated association to mortality: indexed right ventricular (RV) volumes and stroke volume, right ventricular ejection fraction (RVEF), indexed RV mass, septal angle, pulmonary artery systolic/diastolic area and its relative area change. In multivariate regression, only three variables were independently associated with mortality: RVEF (HR 0.64, P < 0.001), indexed RV mass (HR 1.46, P < 0.001) and IV septal angle (HR 1.48, P < 0.001). Our CMR model had 0.76 area under the curve (P < 0.001) to predict mortality. This study confirms that pulmonary hypertension in patients with HFpEF is associated with a poor prognosis and we observe that CMR can risk stratify these patients and predict all-cause mortality. When patients with HFpEF develop pulmonary hypertension, CMR measures that reflect right ventricular afterload and function predict all-cause mortality. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| ISSN: |
1569-5794 |
| Relation: |
https://eprints.whiterose.ac.uk/id/eprint/174336/1/Garg2021_Article_CardiovascularMagneticResonanc.pdf; Garg, P., Lewis, R.A., Johns, C.S. et al. (11 more authors) (2021) Cardiovascular magnetic resonance predicts all-cause mortality in pulmonary hypertension associated with heart failure with preserved ejection fraction. International Journal of Cardiovascular Imaging, 37 (10). pp. 3019-3025. ISSN: 1569-5794 |
| Availability: |
https://eprints.whiterose.ac.uk/id/eprint/174336/; https://eprints.whiterose.ac.uk/id/eprint/174336/1/Garg2021_Article_CardiovascularMagneticResonanc.pdf |
| Rights: |
cc_by_4 |
| Accession Number: |
edsbas.D9289104 |
| Database: |
BASE |