Cardiac Magnetic Resonance Imaging as a Prognostic Biomarker in Treatment-Naïve Pulmonary Hypertension

Publication date: Available online 10 December 2019Source: European Journal of RadiologyAuthor(s): Arun Jose, Akhil Kher, Robert E. O’Donnell, Jean M. ElwingAbstractPurposeTargeted treatment for pulmonary arterial hypertension (PAH), diagnosed via right heart catheterization (RHC), has been shown to improve morbidity and mortality. Identifying characteristics that predict clinical worsening has been challenging. We sought to evaluate the role of cardiac Magnetic Resonance Imaging (CMR) as a predictor of clinical worsening in a cohort of treatment-naïve pulmonary hypertension (PH) patients.MethodsWe performed a retrospective single center analysis of all adults with newly diagnosed treatment-naïve PH between January 1st 2013 and January 1st 2019. Patients with World Health Organization (WHO)-Group I PAH or WHO-Group II/III PH disease, who underwent both CMR (Signa Horizon 1.5 T, General Electric, Milwaukee, WI and Siemens Espree 1.5 T, Munich, Germany) and RHC testing prior to targeted PAH treatment, were included for analysis. Cox proportional hazards models were constructed.ResultsA total of 38 patients, of which 12 (32%) experienced the primary outcome of clinical worsening. were included in the final analysis, Patients with clinical worsening were significantly more likely to have RV dysfunction by CMR (including lower RV ejection fraction (HR 0.93, p = 0.007) and more RV dilation (HR 1.02, p = 0.005-0.021)) and RHC...
Source: European Journal of Radiology - Category: Radiology Source Type: research

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ConclusionECV in PH as obtained using CMR appears to correlate with known echocardiographic prognostic markers and more specifically with the markers, which assess RV systolic function.
Source: Diagnostic and Interventional Imaging - Category: Radiology Source Type: research
Conditions:   Congenital Heart Disease;   Pulmonary Arterial Hypertension Interventions:   Other: 4D Flow magnetic resonance imagery;   Procedure: Cardiac catheterization Sponsor:   Centre Chirurgical Marie Lannelongue Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
The function of the right ventricle determines the fate of patients with pulmonary hypertension. Since right heart failure is the consequence of increased afterload, a full physiological description of the cardiopulmonary unit consisting of both the right ventricle and pulmonary vascular system is required to interpret clinical data correctly. Here, we provide such a description of the unit and its components, including the functional interactions between the right ventricle and its load. This physiological description is used to provide a framework for the interpretation of right heart catheterisation data as well as imag...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Original Articles: World Symposium on Pulmonary Hypertension Source Type: research
Publication date: December 2018Source: Revista Portuguesa de Cardiologia (English Edition), Volume 37, Issue 12Author(s): Sílvia Aguiar Rosa, Ana Figueiredo Agapito, Marta António, Lídia de Sousa, José Alberto Oliveira, Sérgio Laranjo, Susana Martins, Nuno Jalles Tavares, Fátima F. Pinto, Rui Cruz FerreiraAbstractUhl's disease, also known as Uhl anomaly, is a rare disease secondary to selective but uncontrolled apoptosis of right ventricular myocytes during the perinatal period, after complete cardiac development, leading to the absence of right ventricular myocardium and the direc...
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research
ConclusionsRiociguat treatment was associated with increased RV stroke volume index and trends for improvement in myocardial remodelling in patients with CTEPH. A larger clinical study is warranted to observe the therapeutic benefits of riociguat on RV remodelling.RésuméContexteLes effets du traitement par le riociguat sur le métabolisme, la perfusion et le débit du ventricule droit (VD) chez les patients atteints d’hypertension pulmonaire thromboembolique chronique (HPTC) sont inconnus. Dans la présente étude, nous analysons les changements aux ventriculaires droits associ&e...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Publication date: Available online 2 May 2018Source: Academic RadiologyAuthor(s): Sabine K. Maschke, Christian O. Schoenfeld, Till F. Kaireit, Serghei Cebotari, Karen Olsson, Marius Hoeper, Frank Wacker, Jens Vogel-ClaussenRationale and ObjectivesThe aim of this study was to assess regional myocardial function in patients with chronic thromboembolic hypertension (CTEPH) before and after successful pulmonary endarterectomy (PEA) using magnetic resonance imaging.MethodsTwenty-two patients with CTEPH underwent cardiac magnetic resonance imaging before and 12 (11, 17) days after PEA. Mean pulmonary artery pressure was evaluate...
Source: Academic Radiology - Category: Radiology Source Type: research
ConclusionsRiociguat treatment was associated with increased RVSVI and trends for improvement in myocardial remodeling in CTEPH patients. A larger clinical study is warranted to observe the therapeutic benefits of riociguat on RV remodeling.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Publication date: Available online 2 May 2018Source: Academic RadiologyAuthor(s): Sabine K. Maschke, Christian O. Schoenfeld, Till F. Kaireit, Serghei Cebotari, Karen Olsson, Marius Hoeper, Frank Wacker, Jens Vogel-ClaussenRationale and ObjectivesThe aim of this study was to assess regional myocardial function in patients with chronic thromboembolic hypertension (CTEPH) before and after successful pulmonary endarterectomy (PEA) using magnetic resonance imaging.MethodsTwenty-two patients with CTEPH underwent cardiac magnetic resonance imaging before and 12 (11, 17) days after PEA. Mean pulmonary artery pressure was evaluate...
Source: Academic Radiology - Category: Radiology Source Type: research
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