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Cardiac magnetic resonance-derived right ventricular outflow tract systolic flow acceleration: a novel index of right ventricular function and prognosis in patients with pulmonary arterial hypertension

Authors
 Ki-Woon Kang  ;  Hyuk-Jae Chang  ;  Yeon Pyo Yoo  ;  Hyeon Soo Yoon  ;  Young-Jin Kim  ;  Byoung-Wook Choi  ;  Chi-Young Shim  ;  Jongwon Ha  ;  Namsik Chung 
Citation
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, Vol.29(8) : 1759-1767, 2013 
Journal Title
INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
ISSN
 1569-5794 
Issue Date
2013
MeSH
Acceleration ; Adult ; Area Under Curve ; Cardiac Catheterization ; Familial Primary Pulmonary Hypertension ; Female ; Hemodynamics ; Humans ; Hypertension, Pulmonary/complications ; Hypertension, Pulmonary/diagnosis* ; Hypertension, Pulmonary/physiopathology ; Magnetic Resonance Imaging, Cine* ; Male ; Middle Aged ; Myocardial Contraction ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; ROC Curve ; Reproducibility of Results ; Stroke Volume ; Time Factors ; Ventricular Dysfunction, Right/diagnosis* ; Ventricular Dysfunction, Right/etiology ; Ventricular Dysfunction, Right/physiopathology ; Ventricular Function, Right* ; Ventricular Pressure
Keywords
Right ventricular function ; Right ventricular systolic flow acceleration
Abstract
To validate the right ventricular outflow tract systolic flow acceleration (RVOTACC; peak flow velocity/time-to-peak velocity) measured by phase-contrast (PC)—cardiovascular magnetic resonance (CMR) as a novel index of right ventricular (RV) function, and to investigate its clinical implications in patients with pulmonary arterial hypertension (PAH). Thirty (38 % male, 43 ± 15 years old) out of 55 consecutive patients who were initially diagnosed with PAH at the referral center were prospectively enrolled between March 2009 and July 2010 and were followed for PAH-related cardiovascular events for 2 years. The invasively measured maximum dP/dt (dP/dtmax) was used as an index of RV contractility. The PC-CMR-derived RVOTACC was compared with well-known prognostic parameters. The PC-CMR-derived RVOTACC correlated strongly with the dP/dtmax and estimated RV function more accurately than the CMR-derived RV ejection fraction. The CMR-derived RVOTACC level (HR = 0.87, 95 % CI 0.78–0.98, p = 0.038) could be another powerful prognostic index compared with the functional capacity (hazard ratio [HR] = 0.88, 95 % confidence interval [CI] 0.78–0.97, p = 0.035) and REVEAL Registry risk score (HR = 0.83, CI 0.56–0.95, p = 0.012). Furthermore, receiver-operating characteristic analysis identified ≥0.4 m/s2 as the optimal RVOTACC cut-off for predicting subsequent cardiovascular events. PC-CMR-derived RVOTACC is a promising non-invasively measured index of RV function and prognosis in patients with PAH.
Full Text
http://link.springer.com/article/10.1007%2Fs10554-013-0262-2
DOI
10.1007/s10554-013-0262-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Chung, Nam Sik(정남식)
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89040
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