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Right ventricular dimension index by cardiac magnetic resonance for prognostication in connective tissue diseases and pulmonary hypertension

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Title: Right ventricular dimension index by cardiac magnetic resonance for prognostication in connective tissue diseases and pulmonary hypertension
Authors: Abe, Nobuya Browse this author
Kato, Masaru Browse this author →KAKEN DB
Kono, Michihito Browse this author →KAKEN DB
Fujieda, Yuichiro Browse this author →KAKEN DB
Ohira, Hiroshi Browse this author →KAKEN DB
Tsujino, Ichizo Browse this author →KAKEN DB
Oyama-Manabe, Noriko Browse this author →KAKEN DB
Oku, Kenji Browse this author →KAKEN DB
Bohgaki, Toshiyuki Browse this author →KAKEN DB
Yasuda, Shinsuke Browse this author →KAKEN DB
Atsumi, Tatsuya Browse this author →KAKEN DB
Keywords: magnetic resonance imaging
propensity score
pulmonary hypertension
right ventricular dimension
Issue Date: Mar-2020
Publisher: Oxford University Press
Journal Title: Rheumatology
Volume: 59
Issue: 3
Start Page: 622
End Page: 633
Publisher DOI: 10.1093/rheumatology/kez336
Abstract: Objectives. Pulmonary hypertension (PH) in patients with CTD is a heterogeneous condition affected by left heart disease, chronic lung disease and thromboembolism as well as pulmonary vascular disease. Recent studies using cardiac magnetic resonance (CMR) have shown that right ventricular dysfunction is predictive for mortality in patients with PH, but limited to pulmonary arterial hypertension. This study aimed to analyse prognostic factors in PH-CTD. Methods. This retrospective analysis comprised 84 CTD patients, including SSc, who underwent both CMR and right heart catheterization from 2008 to 2018. Demographics, laboratory findings, and haemodynamic and morphological parameters were extracted. The prognostic value of each parameter was evaluated by multivariate analysis using covariables derived from propensity score to control confounding factors. Results. Of 84 patients, 65 had right heart catheterization-confirmed PH (54 pulmonary arterial hypertension, 11 non-pulmonary arterial hypertension). Nine out of these PH patients died during a median follow-up period of 25 months. In 65 patients with PH, right ventricular end-diastolic dimension index (RVEDDI) evaluated by CMR was independently associated with mortality (hazard ratio 1.24; 95% CI: 1.08-1.46; P = 0.003). In a receiver operating characteristic analysis, RVEDDI highly predicted mortality, with area under the curve of 0.87. The 0.5-2-year follow-up data revealed that RVEDDI in both survivors and non-survivors did not significantly change over the clinical course, leading to the possibility that an early determination of RVEDDI could predict the prognosis. Conclusion. RVEDDI simply evaluated by CMR could serve as a significant predictor of mortality in PH-CTD. A further validation cohort study is needed to confirm its usability.
Rights: This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record Nobuya Abe, Masaru Kato, Michihito Kono, Yuichiro Fujieda, Hiroshi Ohira, Ichizo Tsujino, Noriko Oyama-Manabe, Kenji Oku, Toshiyuki Bohgaki, Shinsuke Yasuda, Tatsuya Atsumi, Right ventricular dimension index by cardiac magnetic resonance for prognostication in connective tissue diseases and pulmonary hypertension. Rheumatology (Oxford), Volume 59, Issue 3, March 2020, Pages 622-633 is available online at: https://doi.org/10.1093/rheumatology/kez336.
Type: article (author version)
URI: http://hdl.handle.net/2115/80500
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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