Changes in right ventricular function measured by cardiac magnetic resonance imaging in patients receiving pulmonary arterial hypertension-targeted therapy the EURO-MR study

Andrew J. Peacock, Stephen Crawley, Lindsey McLure, Kevin Blyth, Carmine Dario Vizza, Roberto Poscia, Marco Francone, Ilaria Iacucci, Horst Olschewski, Gabor Kovacs, Anton Vonk Noordegraaf, J. Tim Marcus, Marielle C. Van De Veerdonk, Frank P T Oosterveer

Research output: Contribution to journalArticle

Abstract

Background-Most measures that predict survival in pulmonary hypertension (PH) relate directly to, or correlate with, right ventricular (RV) function. Direct assessment of RV function using noninvasive techniques such as cardiac MRI may therefore be an appropriate way of determining response to therapy and monitoring disease progression in PH. Methods and Results-In this pan-European study, 91 patients with PH (mean pulmonary arterial pressure 46±15 mm Hg) underwent clinical and cardiac MRI assessments at baseline and after 12 months of disease-targeted therapy (predominantly endothelin receptor antagonists [47.3%] or phosphodiesterase type-5 inhibitors [25.3%]). At month 12, functional class had improved in 21 patients, was unchanged in 63 patients, and had deteriorated in 7 patients. Significant improvements were achieved in RV and left ventricular ejection fraction ( >0.001 and P=0.0007, respectively), RV stroke volume index ( >0.0001), and left ventricular end-diastolic volume index (P=0.0015). Increases in 6-minute walk distance were significant ( >0.0001) and correlated with change in RV ejection fraction and left ventricular end-diastolic volume, although correlation coefficients were low (r=0.28, P=0.01 and r=0.26, P=0.02, respectively). Conclusions-On-treatment changes in cardiac MRI-derived variables from left and right sides of the heart reflected changes in functional class and survival in patients with PH. Direct measurement of RV function using cardiac MRI can fully assess potential benefits of treatment in PH.

Original languageEnglish
Pages (from-to)107-114
Number of pages8
JournalCirculation: Cardiovascular Imaging
Volume7
Issue number1
DOIs
Publication statusPublished - 2014

Keywords

  • Hypertension
  • Magnetic resonance imaging
  • Pulmonary
  • Right ventricle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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  • Cite this

    Peacock, A. J., Crawley, S., McLure, L., Blyth, K., Vizza, C. D., Poscia, R., Francone, M., Iacucci, I., Olschewski, H., Kovacs, G., Vonk Noordegraaf, A., Marcus, J. T., Van De Veerdonk, M. C., & Oosterveer, F. P. T. (2014). Changes in right ventricular function measured by cardiac magnetic resonance imaging in patients receiving pulmonary arterial hypertension-targeted therapy the EURO-MR study. Circulation: Cardiovascular Imaging, 7(1), 107-114. https://doi.org/10.1161/CIRCIMAGING.113.000629