Hiroyuki Kamide1, Shingo Kato2,3, Keigo Hayakawa4, Kazuki Fukui4, Hideya Kitamura5, Takashi Ogura5, Tae Iwasawa6, Kazuo Kimura7, Kouichi Tamura8, Daisuke Utsunomiya1. 1. Department of Diagnostic Radiology, Yokohama City University, Yokohama, Japan. 2. Department of Diagnostic Radiology, Yokohama City University, Yokohama, Japan. shingo.m12226@gmail.com. 3. Departments of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. shingo.m12226@gmail.com. 4. Departments of Cardiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. 5. Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. 6. Department of Radiology, Kanagawa Cardiovascular and Respiratory Center, Yokohama, Japan. 7. Department of Cardiology, Yokohama City Medical Center, Yokohama, Japan. 8. Department of Medical Science and Cardiorenal Medicine, Yokohama City University, Yokohama, Japan.
Abstract
OBJECTIVES: The aims of this study were to investigate the relationship between pulmonary hypertension (PH) and right ventricular (RV) strain, and to evaluate the prognostic value of RV strain by cardiac magnetic resonance (CMR) feature tracking for patients with interstitial lung disease (ILD). METHODS: A total of seventy ILD patients (mean age: 71 ± 8 years, 39 [56%] males) who underwent CMR and right heart catheterization (RHC) were studied. Using a 1.5T magnetic resonance (MR) scanner, steady-state free precession cine MR images encompassing the RV were acquired in all patients and 20 control subjects. RV longitudinal strain were calculated with a feature tracking algorithm. PH was defined as a mean pulmonary artery pressure of more than 20 mmHg at rest and a pulmonary vascular resistance ≥3 Woods unit. RESULTS: The RV longitudinal strain was significantly impaired in the ILD patients with PH (n=18) than ILD patients without PH (n=52) (-13.3 ± 5.4% vs. -16.9±5.4%, p=0.048). The RV longitudinal strain differed significantly between the ILD patients without PH and the controls (n=20) (-16.9 ± 5.4% vs. -20.8 ± 6.2%, p=0.002). Five of 70 (7%) patients died within one-year after CMR scan. Area under receiver operating characteristics curve for predicting death was 0.900 (95%CI: 0.800 to 1.000) for RV strain, 0.643 (95%CI: 0.454 to 0.832) for RVEF. CONCLUSIONS: Presence of PH was associated with impairment of RV strain, and RV strain could predict short-term mortality in patients with ILD. RV strain by feature tracking might be useful as a non-invasive prognostic marker for patients with ILD.
OBJECTIVES: The aims of this study were to investigate the relationship between pulmonary hypertension (PH) and right ventricular (RV) strain, and to evaluate the prognostic value of RV strain by cardiac magnetic resonance (CMR) feature tracking for patients with interstitial lung disease (ILD). METHODS: A total of seventy ILDpatients (mean age: 71 ± 8 years, 39 [56%] males) who underwent CMR and right heart catheterization (RHC) were studied. Using a 1.5T magnetic resonance (MR) scanner, steady-state free precession cine MR images encompassing the RV were acquired in all patients and 20 control subjects. RV longitudinal strain were calculated with a feature tracking algorithm. PH was defined as a mean pulmonary artery pressure of more than 20 mmHg at rest and a pulmonary vascular resistance ≥3 Woods unit. RESULTS: The RV longitudinal strain was significantly impaired in the ILDpatients with PH (n=18) than ILDpatients without PH (n=52) (-13.3 ± 5.4% vs. -16.9±5.4%, p=0.048). The RV longitudinal strain differed significantly between the ILDpatients without PH and the controls (n=20) (-16.9 ± 5.4% vs. -20.8 ± 6.2%, p=0.002). Five of 70 (7%) patientsdied within one-year after CMR scan. Area under receiver operating characteristics curve for predicting death was 0.900 (95%CI: 0.800 to 1.000) for RV strain, 0.643 (95%CI: 0.454 to 0.832) for RVEF. CONCLUSIONS: Presence of PH was associated with impairment of RV strain, and RV strain could predict short-term mortality in patients with ILD. RV strain by feature tracking might be useful as a non-invasive prognostic marker for patients with ILD.
Entities:
Keywords:
Interstitial lung diseases; Magnetic resonance; Pulmonary hypertension
Authors: Paul Carter; Jakub Lagan; Christien Fortune; Deepak L Bhatt; Jørgen Vestbo; Robert Niven; Nazia Chaudhuri; Erik B Schelbert; Rahul Potluri; Christopher A Miller Journal: J Am Coll Cardiol Date: 2019-03-04 Impact factor: 24.094
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