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Deprecated: Implicit conversion from float 265.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Pulm+Circ 2017 ; 7 (2): 465-75 Nephropedia Template TP
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Dobutamine stress MRI in pulmonary hypertension: relationships between stress pulmonary artery relative area change, RV performance, and 10-year survival #MMPMID28597775
Pulm Circ 2017[Jun]; 7 (2): 465-75 PMID28597775show ga
In pulmonary hypertension (PH), right ventricular (RV) performance determines survival. Pulmonary artery (PA) stiffening is an important biomechanical event in PH and also predicts survival based on the PA relative area change (RAC) measured at rest using magnetic resonance imaging (MRI). In this exploratory study, we sought to generate novel hypotheses regarding the influence of stress RAC on PH prognosis and the interaction between PA stiffening, RV performance and survival. Fifteen PH patients underwent dobutamine stress-MRI (ds-MRI) and right heart catheterization. RACREST, RACSTRESS, and ?RAC (RAC STRESS ? RAC REST) were correlated against resting invasive hemodynamics and ds-MRI data regarding RV performance and RV-PA coupling efficiency (n?vv [RV stroke volume/RV end-systolic volume]). The impact of RAC, RV data, and n?vv on ten-year survival were determined using Kaplan?Meier analysis. PH patients with a low ?RAC (2.6%) had a worse long-term survival (log-rank P?=?0.045, HR for death?=?4.46 [95% CI?=?1.08?24.5]) than those with ?RAC????2.6%. Given the small sample, these data should be interpreted with caution; however, low ?RAC was associated with an increase in stress diastolic PA area indicating proximal PA stiffening. Associations of borderline significance were observed between low RACSTRESS and low n?vvSTRESS, ???VV, and ?RVEF. Further studies are required to validate the potential prognostic impact of ?RAC and the biomechanics potentially connecting low ?RAC to shorter survival. Such studies may facilitate development of novel PH therapies targeted to the proximal PA.