Ventricular mass discriminates pulmonary arterial hypertension as redefined at the Sixth World Symposium on Pulmonary Hypertension.
Ventricular mass discriminates pulmonary arterial hypertension as redefined at the Sixth World Symposium on Pulmonary Hypertension.
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DOI：
10.1002/pul2.12005
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发表时间：
2022-01
影响因子：
2.6
通讯作者：
Hassoun, Paul M.
中科院分区：
文献类型：
--
作者：
Simpson, Catherine E.;Kolb, Todd M.;Hsu, Steven;Zimmerman, Stefan L.;Corona-Villalobos, Celia P.;Mathai, Stephen C.;Damico, Rachel L.;Hassoun, Paul M.
心脏磁共振（CMR）测量右心室（RV）质量、体积和功能对肺动脉高压（PAH）具有诊断和预后价值。我们假设，基于RV质量的指标将区分第六届世界肺动脉高压研讨会（第六届WSPH）上重新定义的平均肺动脉压（mPAP）阈值>20 mmHg的事件PAH。89例疑似PAH受试者接受了CMR成像，包括64例系统性硬化症（SSc）受试者。测量CMR指标，包括RV和左心室（LV）质量。所有受试者在CMR后48 h内接受右心导管插入术（RHC）以评估血流动力学。使用广义线性模型，评估CMR指标与PAH之间的相关性，确定用于预测PAH的CMR变量的最佳子集，并检查基于质量的指标、血流动力学和其他预测性CMR指标之间的关系。59例受试者符合第6版WSPH PAH标准。RV质量指标（包括心室质量指数（VMI））显示患有与不患有PAH的受试者之间的最大幅度差异。总体而言，在SSc中，通过CMR测量的VMI和RV质量是在RHC时区分PAH的最具预测性的变量，受试者工作特征曲线下面积为0.86和0.83。分别VMI随肺血管阻力和PAH患者的mPAP呈线性增加，包括轻度PAH相关的mPAP较低范围。VMI ≥ 0.37对鉴别PAH的阳性预测值为90%。通过CMR测量的RV质量指标，包括VMI，区分第6个WSPH标准定义的偶发、未经治疗的PAH。
Cardiac magnetic resonance (CMR) measures of right ventricular (RV) mass, volumes, and function have diagnostic and prognostic value in pulmonary arterial hypertension (PAH). We hypothesized that RV mass‐based metrics would discriminate incident PAH as redefined by the lower mean pulmonary arterial pressure (mPAP) threshold of >20 mmHg at the Sixth World Symposium on Pulmonary Hypertension (6th WSPH). Eighty‐nine subjects with suspected PAH underwent CMR imaging, including 64 subjects with systemic sclerosis (SSc). CMR metrics, including RV and left ventricular (LV) mass, were measured. All subjects underwent right heart catheterization (RHC) for assessment of hemodynamics within 48 h of CMR. Using generalized linear models, associations between CMR metrics and PAH were assessed, the best subset of CMR variables for predicting PAH were identified, and relationships between mass‐based metrics, hemodynamics, and other predictive CMR metrics were examined. Fifty‐nine subjects met 6th WSPH criteria for PAH. RV mass metrics, including ventricular mass index (VMI), demonstrated the greatest magnitude difference between subjects with versus without PAH. Overall and in SSc, VMI and RV mass measured by CMR were among the most predictive variables discriminating PAH at RHC, with areas under the receiver operating characteristic curve 0.86 and 0.83. respectively. VMI increased linearly with pulmonary vascular resistance and with mPAP in PAH, including in lower ranges of mPAP associated with mild PAH. VMI ≥ 0.37 yielded a positive predictive value of 90% for discriminating PAH. RV mass metrics measured by CMR, including VMI, discriminate incident, treatment‐naïve PAH as defined by 6th WSPH criteria.
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影响因子：
19.7
作者：
Johns CS;Kiely DG;Rajaram S;Hill C;Thomas S;Karunasaagarar K;Garg P;Hamilton N;Solanki R;Capener DA;Elliot C;Sabroe I;Charalamopopoulos A;Condliffe R;Wild JM;Swift AJ
通讯作者：
Swift AJ
影响因子：
9.6
作者：
Chaisson, Neal F.;Hassoun, Paul M.
通讯作者：
Hassoun, Paul M.
DOI：
10.1164/rccm.202012-4317so
发表时间：
2021-06-15
影响因子：
24.7
作者：
Maron, Bradley A.;Abman, Steven H.;Rosenzweig, Erika B.
通讯作者：
Rosenzweig, Erika B.
影响因子：
4.7
作者：
Chung, Lorinda;Domsic, Robyn T.;Steen, Virginia D.
通讯作者：
Steen, Virginia D.
DOI：
10.1164/rccm.201909-1771oc
发表时间：
2020-02-15
影响因子：
24.7
作者：
Lewis, Robert A.;Johns, Christopher S.;Kiely, David G.
通讯作者：
Kiely, David G.