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Right atrial emptying fraction non-invasively predicts mortality in pulmonary hypertension.
- Source :
-
The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2016 Jul; Vol. 32 (7), pp. 1121-30. Date of Electronic Publication: 2016 Apr 13. - Publication Year :
- 2016
-
Abstract
- Right-sided heart failure is the most common cause of death in pulmonary hypertension (PH). Echocardiographic measurements of right atrial (RA) size are associated with worse outcome in PH, however the association between RA function and death in PH has not been well-described. 160 PH patients (World Health Organization groups 1-5) underwent cardiac magnetic resonance imaging (cMRI) and right heart catheterization (RHC) within 6 weeks of each other at a tertiary care academic medical center in the United States. We measured cMRI RA maximum and minimum volumes indexed to body surface area and calculated RA emptying fraction (RAEF). We evaluated the relationship between RAEF and clinical variables with death using Cox proportional hazard models. 57 deaths occurred during a median follow-up of 3.5 years (36 % died overall, 10 % per year). RAEF was directly correlated in univariate analyses with right ventricular (RV) ejection fraction, left ventricular (LV) ejection fraction, LV size, cardiac index, absence of tricuspid and pulmonic regurgitation, absence of pericardial effusion, estimated glomerular filtration rate, 6-minute walk distance, and pulmonary arterial oxygen saturation, whereas it was inversely correlated with death, BNP, heart rate, mean RA pressure, mean PA pressure, pulmonary and systemic vascular resistance, RV size, and RA size. Using multivariate analyses, RAEF had a robust inverse association with death after adjusting for measured risk factors (HR per 5 % change in RAEF: 0.83 [95 % CI 0.73-0.94], p = 0.003). In PH patients, decreased RAEF by cMRI is independently associated with worse survival after adjustment for other risk factors.
- Subjects :
- Adult
Aged
Cardiac Catheterization
Cause of Death
Female
Heart Failure diagnosis
Heart Failure physiopathology
Humans
Hypertension, Pulmonary diagnosis
Hypertension, Pulmonary physiopathology
Kaplan-Meier Estimate
Magnetic Resonance Imaging, Cine
Male
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk Factors
Stroke Volume
Tertiary Care Centers
Texas
Time Factors
Ventricular Function, Left
Ventricular Function, Right
Atrial Function, Right
Heart Failure mortality
Hypertension, Pulmonary mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1875-8312
- Volume :
- 32
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The international journal of cardiovascular imaging
- Publication Type :
- Academic Journal
- Accession number :
- 27076226
- Full Text :
- https://doi.org/10.1007/s10554-016-0883-3