Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, 242 Guangji Road, Suzhou, 215008, Jiangsu, China.
Department of Radiology, Tianjin Medical University General Hospital, 154 Anshan Road, Tianjin, 300052, China.
Eur Radiol. 2021 Sep;31(9):7121-7131. doi: 10.1007/s00330-021-07835-8. Epub 2021 Mar 18.
This study aimed to compare the cardiac function among different sub-types of pulmonary hypertension (PH) and to explore the independent predictors of major adverse cardiovascular events (MACE).
Eighty-seven PH patients diagnosed by right heart catheterization (RHC) were recruited. Patients underwent cardiac magnetic resonance (CMR) and RHC examination within 2 weeks. The CMR images were analyzed to calculate the cardiac functional parameters including right ventricle (RV) and left ventricle (LV) end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume index (SVI), ejection fraction (EF), tricuspid annular plane systolic excursion (TAPSE), and myocardial mass (MM). The median follow-up time was 46.5 months (interquartile range: 26-65.5 months), and the endpoints were the occurrence of MACE.
RVEDVI, LVEDVI, and LVESVI were higher in congenital heart disease-related PH (CHD-PH) than in other sub-types (p < 0.05). RVMM, RVSVI, and RVCI were highest in CHD-PH. There was no significant difference in the prognosis among different sub-types (p > 0.05). Comparing with the non-MACE group, RVEF, TAPSE, and LVSVI significantly decreased in the MACE group, while the RVESVI significantly increased (p < 0.05). TAPSE ≤ 15.65 mm and LVSVI ≤ 30.27 mL/m were significant independent predictors of prognosis in PH patients.
CHD-PH had a higher RV function reserve but lowest LVEF comparing to other subgroups. TAPSE and LVSVI could contribute to the prediction of MACE in PH patients.
• CMR imaging is a noninvasive and accurate tool to assess ventricular function. • CHD-PH had higher RV function reserve but lowest LVEF. • TAPSE and LVSVI could contribute to the prediction of MACE in PH patients.
本研究旨在比较不同类型肺动脉高压（PH）患者的心脏功能，并探讨主要不良心血管事件（MACE）的独立预测因素。
共纳入 87 例经右心导管检查（RHC）诊断为 PH 的患者。患者在 2 周内接受心脏磁共振（CMR）和 RHC 检查。分析 CMR 图像以计算心脏功能参数，包括右心室（RV）和左心室（LV）舒张末期容积指数（EDVI）、收缩末期容积指数（ESVI）、每搏输出量指数（SVI）、射血分数（EF）、三尖瓣环平面收缩期位移（TAPSE）和心肌质量（MM）。中位随访时间为 46.5 个月（四分位距：26-65.5 个月），终点为 MACE 的发生。
先天性心脏病相关 PH（CHD-PH）患者的 RVEDVI、LVEDVI 和 LVESVI 高于其他亚组（p < 0.05）。CHD-PH 患者的 RVMM、RVSVI 和 RVCI 最高。不同亚组之间的预后无显著差异（p > 0.05）。与非 MACE 组相比，MACE 组的 RVEF、TAPSE 和 LVSVI 显著降低，而 RVESVI 显著升高（p < 0.05）。TAPSE ≤ 15.65mm 和 LVSVI ≤ 30.27mL/m 是 PH 患者预后的独立预测因素。
与其他亚组相比，CHD-PH 具有更高的 RV 功能储备，但 LVEF 最低。TAPSE 和 LVSVI 有助于预测 PH 患者的 MACE。
· CMR 成像 是评估心室功能的一种非侵入性且准确的工具。
· CHD-PH 具有更高的 RV 功能储备，但 LVEF 最低。
· TAPSE 和 LVSVI 有助于预测 PH 患者的 MACE。
