Cardiovascular division, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
CAPES Foundation, Ministry of Education of Brazil, Brasilia, DF, Brazil.
Sci Rep. 2018 May 8;8(1):7200. doi: 10.1038/s41598-018-25259-1.
Right ventricular (RV) end-diastolic volume (EDV) to left ventricular (LV) EDV ratio using cardiovascular magnetic resonance imaging (CMR) is an important parameter for RV size evaluation in additional to indexed EDV. We explore the severity partition for RV dilation using mortality in a population of 62 patients with pulmonary hypertension (PH). Cine short-axis images were acquired with a 1.5 T MR scanner using a steady-state free precession sequence. The optimal cutoff to classify severe RV dilation was determined by a receiver-operating curve (ROC) analysis based on mortality. We further defined mild and moderate categories by the standard deviation distance between normal and severely dilated and found the categories RV dilation by RV/LV volume ratio to be "mild" (1.27-1.69), "moderate" (1.70-2.29) and "severe" (≥2.30). There were significant differences in RVEDV and RV ejection fraction between "mild", "moderate" and "severe" groups (p < 0.001). The "severe" category had a significantly higher mortality when compared to the "non-severe" categories (p < 0.001) while there was no difference among the "non-severe" dilated groups. We have shown that severe RV dilation partition can be defined using mortality with RV/LV volume ratio, which offers an outcome based grading of the "severe" category of RV dilation.
右心室（RV）舒张末期容积（EDV）与左心室（LV）EDV 比值通过心血管磁共振成像（CMR）是 RV 大小评估的重要参数，除了指数 EDV 外。我们在肺动脉高压（PH）的 62 名患者人群中使用死亡率探索 RV 扩张的严重程度分区。使用稳态自由进动序列在 1.5T MR 扫描仪上采集电影短轴图像。通过基于死亡率的接收器操作曲线（ROC）分析确定严重 RV 扩张的最佳截止值。我们进一步通过 RV/LV 容积比定义轻度和中度类别，并发现 RV 扩张的类别为“轻度”（1.27-1.69）、“中度”（1.70-2.29）和“重度”（≥2.30）。在 RVEDV 和 RV 射血分数方面，“轻度”、“中度”和“重度”组之间存在显著差异（p<0.001）。与“非重度”组相比，“重度”组的死亡率显著更高（p<0.001），而“非重度”扩张组之间没有差异。我们已经表明，可以使用 RV/LV 容积比通过死亡率定义严重 RV 扩张分区，这为 RV 扩张的“严重”类别提供了基于结果的分级。
