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Cardiac-MRI Predicts Clinical Worsening and Mortality in Pulmonary Arterial Hypertension

التفاصيل البيبلوغرافية
العنوان: Cardiac-MRI Predicts Clinical Worsening and Mortality in Pulmonary Arterial Hypertension
المؤلفون: Christopher S. Johns, Pankaj Garg, David G. Kiely, Jim M. Wild, Faisal Alandejani, Yousef Shahin, Robin Condliffe, Robert A. Lewis, Andrew J. Swift, Samer Alabed
المصدر: Jacc. Cardiovascular Imaging
بيانات النشر: Elsevier BV, 2021.
سنة النشر: 2021
مصطلحات موضوعية: medicine.medical_specialty, PH, pulmonary hypertension, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, LVEDVI, left ventricular end-diastolic volume index, 0302 clinical medicine, Left ventricular Stroke volume index, systematic review, CTD, connective tissue disease, CMR, cardiac magnetic resonance, pulmonary arterial hypertension, IPAH, idiopathic pulmonary arterial hypertension, Internal medicine, cardiac MRI, Risk of mortality, medicine, Radiology, Nuclear Medicine and imaging, CMR, LV, left ventricular, Original Research, RVMI, right ventricular mass index, mPAP, mean pulmonary artery pressure, Ejection fraction, business.industry, RVEDVI, right ventricular end-diastolic volume index, Hazard ratio, PAH, mortality, VMI, ventricular mass index, meta-analysis, RVESVI, right ventricular end-systolic volume index, Meta-analysis, Rv function, Cardiology, prognosis, Risk of death, PAH, pulmonary arterial hypertension, RV, right ventricular, RVEF, right ventricular ejection fraction, Cardiology and Cardiovascular Medicine, Cardiac magnetic resonance, business
الوصف: Objectives This meta-analysis evaluates assessment of pulmonary arterial hypertension (PAH), with a focus on clinical worsening and mortality. Background Cardiac magnetic resonance (CMR) has prognostic value in the assessment of patients with PAH. However, there are limited data on the prediction of clinical worsening, an important composite endpoint used in PAH therapy trials. Methods The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Web of Science databases were searched in May 2020. All CMR studies assessing clinical worsening and the prognosis of patients with PAH were included. Pooled hazard ratios of univariate regression analyses for CMR measurements, for prediction of clinical worsening and mortality, were calculated. Results Twenty-two studies with 1,938 participants were included in the meta-analysis. There were 18 clinical worsening events and 8 deaths per 100 patient-years. The pooled hazard ratios show that every 1% decrease in right ventricular (RV) ejection fraction is associated with a 4.9% increase in the risk of clinical worsening over 22 months of follow-up and a 2.2% increase in the risk of death over 54 months. For every 1 ml/m2 increase in RV end-systolic volume index or RV end-diastolic volume index, the risk of clinical worsening increases by 1.3% and 0.7%, respectively, and the risk of mortality increases by 0.9% and 1%. Every 1 ml/m2 decrease in left ventricular end-systolic volume index or left ventricular end-diastolic volume index increased the risk of death by 2.1% and 2.3%. Left ventricular parameters were not associated with clinical worsening. Conclusions This review confirms CMR as a powerful prognostic marker in PAH in a large cohort of patients. In addition to confirming previous observations that RV function and RV and left ventricular volumes predict mortality, RV function and volumes also predict clinical worsening. This study provides a strong rationale for considering CMR as a clinically relevant endpoint for trials of PAH therapies.
Central Illustration
وصف الملف: application/pdf
تدمد: 1936-878X
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5d5827486f12c05c9078655d5ffb3e21
https://doi.org/10.1016/j.jcmg.2020.08.013
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....5d5827486f12c05c9078655d5ffb3e21
قاعدة البيانات: OpenAIRE
الوصف
تدمد:1936878X