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Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study

Background and objectives: Non-invasive imaging of the heart has an important place in the diagnosis and management of pulmonary arterial hypertension (PAH). The aim of this study was to establish the thresholds of cardiac magnetic resonance imaging (CMRI)-derived biventricular deformation, function...

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Autores principales: Padervinskiene, Lina, Hoppenot, Deimante, Krivickiene, Ausra, Gumauskiene, Birute, Nedzelskiene, Irena, Simkus, Paulius, Miliauskas, Skaidrius, Jankauskas, Antanas, Basevicius, Algidas, Ereminiene, Egle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230686/
https://www.ncbi.nlm.nih.gov/pubmed/32283599
http://dx.doi.org/10.3390/medicina56040167
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author Padervinskiene, Lina
Hoppenot, Deimante
Krivickiene, Ausra
Gumauskiene, Birute
Nedzelskiene, Irena
Simkus, Paulius
Miliauskas, Skaidrius
Jankauskas, Antanas
Basevicius, Algidas
Ereminiene, Egle
author_facet Padervinskiene, Lina
Hoppenot, Deimante
Krivickiene, Ausra
Gumauskiene, Birute
Nedzelskiene, Irena
Simkus, Paulius
Miliauskas, Skaidrius
Jankauskas, Antanas
Basevicius, Algidas
Ereminiene, Egle
author_sort Padervinskiene, Lina
collection PubMed
description Background and objectives: Non-invasive imaging of the heart has an important place in the diagnosis and management of pulmonary arterial hypertension (PAH). The aim of this study was to establish the thresholds of cardiac magnetic resonance imaging (CMRI)-derived biventricular deformation, function parameters, and levels of N-terminal pro brain natriuretic peptide (NT-proBNP) for the prediction of survival of pre-capillary pulmonary hypertension (PHprecap) patients. Materials and Methods: In total, 64 incident PHprecap cases, who underwent CMRI, were consecutively enrolled in a prospective cohort study. Patients underwent a systemic evaluation, including measurement of NT-proBNP, two-dimensional (2D) echocardiography, six-minute walk test (6MWT), CMRI with feature tracking (FT), and right-heart catheterization (RHC). Patients were divided into two groups according to one-year survival (survival and non-survival groups). Survival analysis was performed. Results: One-year survival was 79.6%. The distribution between age, sex, mean pulmonary artery pressure (mPAP), New York Heart Association (NYHA) functional class, and 6MWT did not differ between the groups. Survival was significantly lower in the PAH group associated with connective tissue disease (CTD-PAH), where 44% (n = 4) of patients died during the first year. Univariate analysis revealed that severely reduced right-ventricle (RV) ejection fraction (EF) <25.5%, left-ventricle global longitudinal strain (LV GLS) >−14.18%, and right pulmonary artery (RPA) relative area change (RAC) <19%, and severely increased NT-proBNP level >1738 (ng/L) indicate an increased risk of death in PH(precap) patients. Conclusions: Impaired RV systolic function and LV global longitudinal strain, decrease of pulmonary artery distensibility, and CTD-PAH etiology, together with high NT-proBNP level, impair prognosis in pre-capillary PH patients. These findings are important for the risk stratification and management of pre-capillary pulmonary hypertension patients.
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spelling pubmed-72306862020-05-22 Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study Padervinskiene, Lina Hoppenot, Deimante Krivickiene, Ausra Gumauskiene, Birute Nedzelskiene, Irena Simkus, Paulius Miliauskas, Skaidrius Jankauskas, Antanas Basevicius, Algidas Ereminiene, Egle Medicina (Kaunas) Article Background and objectives: Non-invasive imaging of the heart has an important place in the diagnosis and management of pulmonary arterial hypertension (PAH). The aim of this study was to establish the thresholds of cardiac magnetic resonance imaging (CMRI)-derived biventricular deformation, function parameters, and levels of N-terminal pro brain natriuretic peptide (NT-proBNP) for the prediction of survival of pre-capillary pulmonary hypertension (PHprecap) patients. Materials and Methods: In total, 64 incident PHprecap cases, who underwent CMRI, were consecutively enrolled in a prospective cohort study. Patients underwent a systemic evaluation, including measurement of NT-proBNP, two-dimensional (2D) echocardiography, six-minute walk test (6MWT), CMRI with feature tracking (FT), and right-heart catheterization (RHC). Patients were divided into two groups according to one-year survival (survival and non-survival groups). Survival analysis was performed. Results: One-year survival was 79.6%. The distribution between age, sex, mean pulmonary artery pressure (mPAP), New York Heart Association (NYHA) functional class, and 6MWT did not differ between the groups. Survival was significantly lower in the PAH group associated with connective tissue disease (CTD-PAH), where 44% (n = 4) of patients died during the first year. Univariate analysis revealed that severely reduced right-ventricle (RV) ejection fraction (EF) <25.5%, left-ventricle global longitudinal strain (LV GLS) >−14.18%, and right pulmonary artery (RPA) relative area change (RAC) <19%, and severely increased NT-proBNP level >1738 (ng/L) indicate an increased risk of death in PH(precap) patients. Conclusions: Impaired RV systolic function and LV global longitudinal strain, decrease of pulmonary artery distensibility, and CTD-PAH etiology, together with high NT-proBNP level, impair prognosis in pre-capillary PH patients. These findings are important for the risk stratification and management of pre-capillary pulmonary hypertension patients. MDPI 2020-04-09 /pmc/articles/PMC7230686/ /pubmed/32283599 http://dx.doi.org/10.3390/medicina56040167 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Padervinskiene, Lina
Hoppenot, Deimante
Krivickiene, Ausra
Gumauskiene, Birute
Nedzelskiene, Irena
Simkus, Paulius
Miliauskas, Skaidrius
Jankauskas, Antanas
Basevicius, Algidas
Ereminiene, Egle
Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study
title Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study
title_full Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study
title_fullStr Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study
title_full_unstemmed Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study
title_short Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study
title_sort identification of cardiac mri and bio-marker thresholds for one-year survival in pre-capillary pulmonary hypertension: prospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230686/
https://www.ncbi.nlm.nih.gov/pubmed/32283599
http://dx.doi.org/10.3390/medicina56040167
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