Prognostic Value of Cardiovascular Magnetic Resonance Imaging Measurements Corrected for Age and Sex in Idiopathic Pulmonary Arterial Hypertension

  • Andrew J. Swift
    From the Unit of Academic Radiology (A.J.S., D.C., J.M.W.) and Design, Trials & Statistics (M.J.C.), The School of Health and Related Research, University of Sheffield, Sheffield, UK; and Sheffield Pulmonary Vascular Disease Unit (J.H., C.E., R.C., D.G.K.), and Radiology Department (S.R., S.T.), Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Smitha Rajaram
    From the Unit of Academic Radiology (A.J.S., D.C., J.M.W.) and Design, Trials & Statistics (M.J.C.), The School of Health and Related Research, University of Sheffield, Sheffield, UK; and Sheffield Pulmonary Vascular Disease Unit (J.H., C.E., R.C., D.G.K.), and Radiology Department (S.R., S.T.), Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Michael J. Campbell
    From the Unit of Academic Radiology (A.J.S., D.C., J.M.W.) and Design, Trials & Statistics (M.J.C.), The School of Health and Related Research, University of Sheffield, Sheffield, UK; and Sheffield Pulmonary Vascular Disease Unit (J.H., C.E., R.C., D.G.K.), and Radiology Department (S.R., S.T.), Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Judith Hurdman
    From the Unit of Academic Radiology (A.J.S., D.C., J.M.W.) and Design, Trials & Statistics (M.J.C.), The School of Health and Related Research, University of Sheffield, Sheffield, UK; and Sheffield Pulmonary Vascular Disease Unit (J.H., C.E., R.C., D.G.K.), and Radiology Department (S.R., S.T.), Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Steve Thomas
    From the Unit of Academic Radiology (A.J.S., D.C., J.M.W.) and Design, Trials & Statistics (M.J.C.), The School of Health and Related Research, University of Sheffield, Sheffield, UK; and Sheffield Pulmonary Vascular Disease Unit (J.H., C.E., R.C., D.G.K.), and Radiology Department (S.R., S.T.), Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Dave Capener
    From the Unit of Academic Radiology (A.J.S., D.C., J.M.W.) and Design, Trials & Statistics (M.J.C.), The School of Health and Related Research, University of Sheffield, Sheffield, UK; and Sheffield Pulmonary Vascular Disease Unit (J.H., C.E., R.C., D.G.K.), and Radiology Department (S.R., S.T.), Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Charlie Elliot
    From the Unit of Academic Radiology (A.J.S., D.C., J.M.W.) and Design, Trials & Statistics (M.J.C.), The School of Health and Related Research, University of Sheffield, Sheffield, UK; and Sheffield Pulmonary Vascular Disease Unit (J.H., C.E., R.C., D.G.K.), and Radiology Department (S.R., S.T.), Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Robin Condliffe
    From the Unit of Academic Radiology (A.J.S., D.C., J.M.W.) and Design, Trials & Statistics (M.J.C.), The School of Health and Related Research, University of Sheffield, Sheffield, UK; and Sheffield Pulmonary Vascular Disease Unit (J.H., C.E., R.C., D.G.K.), and Radiology Department (S.R., S.T.), Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • Jim M. Wild
    From the Unit of Academic Radiology (A.J.S., D.C., J.M.W.) and Design, Trials & Statistics (M.J.C.), The School of Health and Related Research, University of Sheffield, Sheffield, UK; and Sheffield Pulmonary Vascular Disease Unit (J.H., C.E., R.C., D.G.K.), and Radiology Department (S.R., S.T.), Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  • David G. Kiely
    From the Unit of Academic Radiology (A.J.S., D.C., J.M.W.) and Design, Trials & Statistics (M.J.C.), The School of Health and Related Research, University of Sheffield, Sheffield, UK; and Sheffield Pulmonary Vascular Disease Unit (J.H., C.E., R.C., D.G.K.), and Radiology Department (S.R., S.T.), Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.

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<jats:sec> <jats:title>Background—</jats:title> <jats:p>There are limited data on the prognostic value of cardiovascular magnetic resonance measurements in idiopathic pulmonary arterial hypertension, with no studies investigating the impact of correction of cardiovascular magnetic resonance indices for age and sex on prognostic value.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and Results—</jats:title> <jats:p> Consecutive patients with idiopathic pulmonary arterial hypertension underwent cardiovascular magnetic resonance imaging at 1.5T. Steady-state free precession cardiac volumes and mass measurements were corrected for age, sex, and body surface area according to reference data and prognostic significance assessed. A total of 80 patients with idiopathic pulmonary arterial hypertension were identified, and 23 patients died during the mean follow-up of 32±14 months. Corrected for age, sex, and body surface area, right ventricular end-systolic volume ( <jats:italic>P</jats:italic> =0.004) strongly predicted mortality, independent of World Health Organization functional class, mean right atrial pressure, cardiac index, and mixed venous oxygen saturations. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>Consideration should be given to correcting cardiovascular magnetic resonance measures for age, sex, and body surface area, particularly given the changing demographics of patients with idiopathic pulmonary arterial hypertension. Corrected right ventricular end-systolic volume is a strong prognostic marker in idiopathic pulmonary arterial hypertension, independent of invasively derived measurements, mean right atrial pressure cardiac index, and mixed venous oxygen saturations.</jats:p> </jats:sec>

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