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Bi-ventricular interplay in patients with systemic sclerosis-associated pulmonary arterial hypertension : Detection by cardiac magnetic resonance

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Title: Bi-ventricular interplay in patients with systemic sclerosis-associated pulmonary arterial hypertension : Detection by cardiac magnetic resonance
Authors: Noguchi, Atsushi Browse this author
Kato, Masaru Browse this author →KAKEN DB
Kono, Michihito Browse this author
Ohmura, Kazumasa Browse this author
Ohira, Hiroshi Browse this author
Tsujino, Ichizo Browse this author →KAKEN DB
Oyama-Manabe, Noriko Browse this author →KAKEN DB
Oku, Kenji Browse this author
Bohgaki, Toshiyuki Browse this author
Horita, Tetsuya Browse this author →KAKEN DB
Yasuda, Shinsuke Browse this author →KAKEN DB
Nishimura, Masaharu Browse this author →KAKEN DB
Atsumi, Tatsuya Browse this author →KAKEN DB
Keywords: Cardiac magnetic resonance
Connective tissue diseases
Pulmonary arterial hypertension
Systemic sclerosis
Issue Date: 2017
Publisher: Taylor & Francis
Journal Title: Modern rheumatology
Volume: 27
Issue: 3
Start Page: 481
End Page: 488
Publisher DOI: 10.1080/14397595.2016.1218597
PMID: 27535805
Abstract: Objectives: Pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc) has a poor prognosis compared to PAH associated with other connective tissue diseases (CTD). The objective of this study was to examine the difference in hemodynamic state between SSc-PAH and other CTD-PAH by performing cardiac magnetic resonance (CMR) imaging.Methods: A single center retrospective analysis was conducted comprising 40 consecutive CTD patients who underwent right heart catheterization and CMR at the same period from January 2010 to October 2015. Results: Thirty-two patients had pre-capillary pulmonary hypertension. Of these, 15 had SSc and 17 had other CTD. CMR measurements, particularly the ratio of right to left end-diastolic volume (RVEDV/LVEDV), correlated well with mean pulmonary arterial pressure (mPAP). Conversely, RVEDV/LVEDV and mPAP correlated differently in SSc and non-SSc patients. In SSc patients, the ratio of RVEDV/LVEDV to mPAP was significantly higher compared to non-SSc patients. In the follow-up study, 2 SSc patients exhibited increased RVEDV/LVEDV in spite of decreased mPAP following treatment. Kaplan-Meier analysis revealed poor prognosis of patients with increased RVEDV/LVEDV following treatment. Conclusions: Our data indicated that altered bi-ventricular interplay detected at CMR may represent SSc-related cardiac involvement and reflect poor prognosis of SSc-PAH.
Rights: This is an Accepted Manuscript of an article published by Taylor & Francis in Modern Rheumatology in 2017, available online:
Type: article (author version)
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 加藤 将

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