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Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction
BACKGROUND: Right Atrial Volume Index (RAVI) measured by echocardiography is an independent predictor of morbidity in patients with heart failure (HF) with reduced ejection fraction (HFrEF). The aim of this study is to evaluate the predictive value of RAVI assessed by cardiac magnetic resonance (CMR...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378325/ https://www.ncbi.nlm.nih.gov/pubmed/28369148 http://dx.doi.org/10.1371/journal.pone.0173245 |
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author | Ivanov, Alexander Mohamed, Ambreen Asfour, Ahmed Ho, Jean Khan, Saadat A. Chen, Onn Klem, Igor Ramasubbu, Kumudha Brener, Sorin J. Heitner, John F. |
author_facet | Ivanov, Alexander Mohamed, Ambreen Asfour, Ahmed Ho, Jean Khan, Saadat A. Chen, Onn Klem, Igor Ramasubbu, Kumudha Brener, Sorin J. Heitner, John F. |
author_sort | Ivanov, Alexander |
collection | PubMed |
description | BACKGROUND: Right Atrial Volume Index (RAVI) measured by echocardiography is an independent predictor of morbidity in patients with heart failure (HF) with reduced ejection fraction (HFrEF). The aim of this study is to evaluate the predictive value of RAVI assessed by cardiac magnetic resonance (CMR) for all-cause mortality in patients with HFrEF and to assess its additive contribution to the validated Meta-Analysis Global Group in Chronic heart failure (MAGGIC) score. METHODS AND RESULTS: We identified 243 patients (mean age 60 ± 15; 33% women) with left ventricular ejection fraction (LVEF) ≤ 35% measured by CMR. Right atrial volume was calculated based on area in two- and four -chamber views using validated equation, followed by indexing to body surface area. MAGGIC score was calculated using online calculator. During mean period of 2.4 years 33 patients (14%) died. The mean RAVI was 53 ± 26 ml/m(2); significantly larger in patients with than without an event (78.7±29 ml/m(2) vs. 48±22 ml/m(2), p<0.001). RAVI (per ml/m(2)) was an independent predictor of mortality [HR = 1.03 (1.01–1.04), p = 0.001]. RAVI has a greater discriminatory ability than LVEF, left atrial volume index and right ventricular ejection fraction (RVEF) (C-statistic 0.8±0.08 vs 0.55±0.1, 0.62±0.11, 0.68±0.11, respectively, all p<0.02). The addition of RAVI to the MAGGIC score significantly improves risk stratification (integrated discrimination improvement 13%, and category-free net reclassification improvement 73%, both p<0.001). CONCLUSION: RAVI by CMR is an independent predictor of mortality in patients with HFrEF. The addition of RAVI to MAGGIC score improves mortality risk stratification. |
format | Online Article Text |
id | pubmed-5378325 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-53783252017-04-07 Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction Ivanov, Alexander Mohamed, Ambreen Asfour, Ahmed Ho, Jean Khan, Saadat A. Chen, Onn Klem, Igor Ramasubbu, Kumudha Brener, Sorin J. Heitner, John F. PLoS One Research Article BACKGROUND: Right Atrial Volume Index (RAVI) measured by echocardiography is an independent predictor of morbidity in patients with heart failure (HF) with reduced ejection fraction (HFrEF). The aim of this study is to evaluate the predictive value of RAVI assessed by cardiac magnetic resonance (CMR) for all-cause mortality in patients with HFrEF and to assess its additive contribution to the validated Meta-Analysis Global Group in Chronic heart failure (MAGGIC) score. METHODS AND RESULTS: We identified 243 patients (mean age 60 ± 15; 33% women) with left ventricular ejection fraction (LVEF) ≤ 35% measured by CMR. Right atrial volume was calculated based on area in two- and four -chamber views using validated equation, followed by indexing to body surface area. MAGGIC score was calculated using online calculator. During mean period of 2.4 years 33 patients (14%) died. The mean RAVI was 53 ± 26 ml/m(2); significantly larger in patients with than without an event (78.7±29 ml/m(2) vs. 48±22 ml/m(2), p<0.001). RAVI (per ml/m(2)) was an independent predictor of mortality [HR = 1.03 (1.01–1.04), p = 0.001]. RAVI has a greater discriminatory ability than LVEF, left atrial volume index and right ventricular ejection fraction (RVEF) (C-statistic 0.8±0.08 vs 0.55±0.1, 0.62±0.11, 0.68±0.11, respectively, all p<0.02). The addition of RAVI to the MAGGIC score significantly improves risk stratification (integrated discrimination improvement 13%, and category-free net reclassification improvement 73%, both p<0.001). CONCLUSION: RAVI by CMR is an independent predictor of mortality in patients with HFrEF. The addition of RAVI to MAGGIC score improves mortality risk stratification. Public Library of Science 2017-04-03 /pmc/articles/PMC5378325/ /pubmed/28369148 http://dx.doi.org/10.1371/journal.pone.0173245 Text en © 2017 Ivanov et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ivanov, Alexander Mohamed, Ambreen Asfour, Ahmed Ho, Jean Khan, Saadat A. Chen, Onn Klem, Igor Ramasubbu, Kumudha Brener, Sorin J. Heitner, John F. Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction |
title | Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction |
title_full | Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction |
title_fullStr | Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction |
title_full_unstemmed | Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction |
title_short | Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction |
title_sort | right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378325/ https://www.ncbi.nlm.nih.gov/pubmed/28369148 http://dx.doi.org/10.1371/journal.pone.0173245 |
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