Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Cardiac MRI Measurements
Cardiac MRI Volumetric and Functional Measurements
2.2. Pulmonary Artery Distensibility
2.3. Late Gadolinium Enhancement (LGE) Assessment
2.4. Feature Tracking Mechanical Analysis
2.5. Data Analysis
3. Results
Patient Characteristics
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Characteristics | All Patients (N = 49) | Survival (N = 39) | Non-Survival (N = 10) | p-Value |
---|---|---|---|---|
Age (years) | 58.5 (46.38–70.04) | 58.53 (47.67–70.64) | 55.15 (45.18–68.1) | 0.884 |
Women/men | 30 (61.2%)/19 (38.8) | 25 (83.3%)/14 (73.7%) | 5 (16.7%)/5 (26.3%) | 0.419 |
IPAH (n (%)) | 17 (34.7%) | 14 (35.9%) | 3 (33.0%) | 0.363 |
CTD-PAH (n (%)) | 8 (16.3%) | 4 (10.3%) | 4 (44.0%) | 0.012 |
Eisenmenger syndrome (n (%)) | 6 (12.8%) | 5 (12.8%) | 1 (10.0%) | 0.404 |
CTEPH (n (%)) | 14 (28.6%) | 13 (33.3%) | 1 (10.0%) | 0.073 |
PAH other cause (n (%)) | 4 (8.2%) | 3 (7.7%) | 1 (10.0%) | 0.406 |
NYHA class 2/3/4 (n (%)) | 11 (22.44)/28 (57.12)/10 (20.4) | 9 (23.04)/25 (64.0)/5 (12.8) | 2 (20.0)/3 (30.0)/5 (50.0) | 0.708 * |
mPAP (mmHg) | 61.22 ± 18.5 | 61.49 ± 19.1 | 58.75 ± 13.79 | 0.783 |
6MWT (m) | 285.0 (217.5–408.0) | 280.0 (240.0–405.0) | 225(170.0–419.0) | 0.69 |
NT-pro BNP (ng/L) | 1738.0 (469.0–4100.0) | 1472 (398.75–3322.0) | 3683.0 (1902.5–6957.0) | 0.016 |
Parameters | All PH Patients (N = 49) | Survival (N = 39) | Non-Survival (N = 10) | p-Value |
---|---|---|---|---|
RV EDVI (mL/m2) | 85.0 (69.0–104.5) | 84.0 (68.0–101.0) | 87.0 (78.0–125.75) | 0.312 |
RV ESVI (mL/m2) | 53.0 (43.5–70.0) | 50.0 (41.0–65.0) | 67.0 (47.25–82.5) | 0.073 |
RV mass (g/m2) | 53.0 (41.5–59.0) | 53.0 (40.5–57.5) | 54.0 (43.0–77.75) | 0.116 |
RV EF (%) | 37.0 (30.0–45.0) | 38.0 (31.0–46.0) | 30.5 (21.5–40.75) | 0.039 |
RV GLS (%) | −13.8 (−16.6–(−10.5)) | −14.15 (−16.68–(−11.53)) | −10.5 (−18.0–(−8.3)) | 0.134 |
LV EDVI (mL/m2) | 64.0 (54.0–80.5) | 64.0 (55.0–81.0) | 64.0 (46.5–79.0) | 0.604 |
LV ESVI (mL/m2) | 32.0 (20.5–38.5) | 32.0 (20.0–38.0) | 32.0 (22.0–41.75) | 0.213 |
LV EF (%) | 54.0 (46.0–63.0) | 55.0 (46.0–63.0) | 49.0 (42.25–53.75) | 0.140 |
LV GLS (%) | −16.43 (−19.5–(−12.63)) | −17.61 (−19.78–(−15.11)) | −12.17 (−18.57–(−6.85)) | 0.021 |
LV GCS (%) | −31.1 (−34.7–(−25.97)) | −31.6 (−35.82–(−26.39)) | −29.9 (−32.28–(−21.88)) | 0.224 |
RA (cm2) | 30.0 (24.25–35.5) | 29.0 (24.0–34.0) | 33.0 (26.0–39.5) | 0.355 |
LA (cm2) | 21.0 (17.0–27.5) | 22.0 (17.0–28.0) | 18.0 (15.75–22.0) | 0.2 |
Parameters | All Patients (N = 49) | Survival (N = 39) | Non-Survival (N = 10) | p-Value |
---|---|---|---|---|
MPA RAC (%) | 12.88 (8.3–20.63) | 13.25 (8.53–19.8) | 9.26 (5.36–22.26) | 0.254 |
RPA RAC (%) | 15.81 (11.15–23.3) | 19.36 (11.48–23.79) | 11.89 (0.0–15.77) | 0.046 |
LPA RAC (%) | 12.32 (7.55–15.93) | 12.86 (8.57–17.34) | 9.45 (0.0–15.67) | 0.277 |
Parameter (Its Threshold Value) | Area Under the Curve (%) | Sensitivity/Specificity (%) | 1-Year Survival/ Non-Survival n (%) | p-Value | Non-Survival Group OR (95% PI) |
---|---|---|---|---|---|
RV EF <25.5% | 69.1 | 50.0/89.7 | 4 (10.3)/5 (50.0) | 0.011 | 8.75 (1.741–43.973) |
NT-proBNP >1738 (ng/L) | 76.1 | 88.9/60.5 | 15 (39.5)/8 (88.9) | 0.008 | 12.267 (1.389–108.325) |
RPA RAC <19.075% | 77.8 | 100.0/52.8 | 17 (47.2)/5 (100.0) | 0.027 | - |
LV GLS >−14.183% | 75.6 | 77.8/86.7 | 4 (13.3)/7 (77.8) | 0.001 | 22.75 (3.432–150.811) |
Regressors | OR (95% CI); p-Value |
---|---|
Model No. 1 (correct prediction 83.7%, Nagelkerke determination coefficient 0.552) | |
LV GLS >−14.183 | 32.184 (3.145–329.341); 0.003 |
CTD-PAH | 12.499 (1.0–165.877); 0.05 |
Model constant | −3.37, p < 0.001 |
Model No. 2 (correct prediction 83.7%, Nagelkerke determination coefficient 0.325) | |
RV EF <25.5 | 10.12 (1.731–59.15); 0.01 |
CTD-PAH | 7.033 (1.098–45.048); 0.04 |
Model constant | −2.442, p < 0.001 |
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Padervinskiene, L.; Hoppenot, D.; Krivickiene, A.; Gumauskiene, B.; Nedzelskiene, I.; Simkus, P.; Miliauskas, S.; Jankauskas, A.; Basevicius, A.; Ereminiene, E. Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study. Medicina 2020, 56, 167. https://doi.org/10.3390/medicina56040167
Padervinskiene L, Hoppenot D, Krivickiene A, Gumauskiene B, Nedzelskiene I, Simkus P, Miliauskas S, Jankauskas A, Basevicius A, Ereminiene E. Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study. Medicina. 2020; 56(4):167. https://doi.org/10.3390/medicina56040167
Chicago/Turabian StylePadervinskiene, Lina, Deimante Hoppenot, Ausra Krivickiene, Birute Gumauskiene, Irena Nedzelskiene, Paulius Simkus, Skaidrius Miliauskas, Antanas Jankauskas, Algidas Basevicius, and Egle Ereminiene. 2020. "Identification of Cardiac MRI and Bio-Marker Thresholds for One-Year Survival in Pre-Capillary Pulmonary Hypertension: Prospective Study" Medicina 56, no. 4: 167. https://doi.org/10.3390/medicina56040167