| Title: |
Right ventricular remodelling in pulmonary arterial hypertension predicts treatment response |
| Authors: |
Goh, ZM; Balasubramanian, N; Alabed, S; Dwivedi, K; Shahin, Y; Rothman, AMK; Garg, P; Lawrie, A; Capener, D; Thompson, AAR; Alandejani, F; Wild, JM; Johns, CS; Lewis, RA; Gosling, R; Sharkey, M; Condliffe, R; Kiely, DG; Swift, AJ |
| Source: |
1400 ; 1392 |
| Publisher Information: |
BMJ Publishing Group |
| Publication Year: |
2022 |
| Collection: |
Imperial College London: Spiral |
| Description: |
Objectives To determine the prognostic value of patterns of right ventricular adaptation in patients with pulmonary arterial hypertension (PAH), assessed using cardiac magnetic resonance (CMR) imaging at baseline and follow-up. Methods Patients attending the Sheffield Pulmonary Vascular Disease Unit with suspected pulmonary hypertension were recruited into the ASPIRE (Assessing the Spectrum of Pulmonary hypertension Identified at a REferral Centre) Registry. With exclusion of congenital heart disease, consecutive patients with PAH were followed up until the date of census or death. Right ventricular end-systolic volume index adjusted for age and sex and ventricular mass index were used to categorise patients into four different volume/mass groups: low-volume-low-mass, low-volume-high-mass, high-volume-low-mass and high-volume-high-mass. The prognostic value of the groups was assessed with one-way analysis of variance and Kaplan-Meier plots. Transition of the groups was studied. Results A total of 505 patients with PAH were identified, 239 (47.3%) of whom have died at follow-up (median 4.85 years, IQR 4.05). The mean age of the patients was 59±16 and 161 (32.7%) were male. Low-volume-low-mass was associated with CMR and right heart catheterisation metrics predictive of improved prognosis. There were 124 patients who underwent follow-up CMR (median 1.11 years, IQR 0.78). At both baseline and follow-up, the high-volume-low-mass group had worse prognosis than the low-volume-low-mass group (p |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
Heart; http://hdl.handle.net/10044/1/109618 |
| DOI: |
10.1136/heartjnl-2021-320733 |
| Availability: |
http://hdl.handle.net/10044/1/109618; https://doi.org/10.1136/heartjnl-2021-320733 |
| Rights: |
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. ; https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.E8BDC280 |
| Database: |
BASE |