Prognosis value of cardiac magnetic resonance cardiac function index in patients with pulmonary hypertension
10.16781/j.0258-879x.2019.03.0262
- Author:
Wen REN
1
Author Information
1. Department of Radiology, Tianjin Medical University General Hospital
- Publication Type:Journal Article
- Keywords:
Cardiac function;
Magnetic resonance imaging;
Prognosis;
Pulmonary hypertension
- From:
Academic Journal of Second Military Medical University
2019;40(3):262-269
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of cardiac magnetic resonance (CMR) imaging parameters on prognosis of the patients with pulmonary hypertension (PH). Methods Ninety PH patients, who were diagnosed by right heart catheterization and received CMR examination in our hospital, were enrolled for this study. The cardiac functional parameters, including end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume index (SVI) and ejection fraction (EF) of the right ventricle and left ventricle, and tricuspid annular plane systolic excursion (TAPSE), were analyzed. The study end-point was major adverse cardiovascular event (MACE). Two independent sample t test was used to analyze the differences of CMR parameters between MACE group and non-MACE group. Cox proportional hazards regression model was used to determine the independent predictors of end-point events. Kaplan-Meier survival curve was drawn based on the optimal cut-off value of receiver operating characteristic (ROC) curve. Results Compared with the non-MACE group, the right ventricular EF, left ventricular SVI and TAPSE were decreased in the MACE group ([27.00±9.92]% vs [32.68±11.34]%, [29.14±8.73] mL/m2 vs [35.41±11.59] mL/m2 and [12.51±4.17] mm vs [16.04±7.37] mm), while the right ventricular EDVI and ESVI were increased ([139.72±48.70] mL/m2 vs [116.07± 44.79] mL/m2 and [104.26±42.88] mL/m2 vs [79.37±35.67] mL/m2), and the differences were significant (t=-2.065, -2.286, -2.089, 2.076 and 2.668, all P<0.05). Multivariate analysis showed that left ventricular SVI and TAPSE were independent predictors of MACE in the PH patients (hazard ratio [HR]=0.942 and 0.904, P=0.039 and 0.022). The optimal cut-off values of left ventricular SVI and TAPSE determined by ROC curve were 30.27 mL/m2 and 15.65 mm, respectively. Kaplan-Meier survival analysis showed that the incidence of MACE was significantly increased when left ventricular SVI≤30.27 mL/m2 or TAPSE≤15.65 mm (P=0.001 and 0.019). Conclusion The left and right heart functions of PH patients with MACE are poor. TAPSE and left ventricular SVI are the independent predictors of MACE in the PH patients.
