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

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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

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Right Ventricular Function
Pulmonary Hypertension
Stroke Volume
Magnetic Resonance Imaging
Therapeutics
Phosphodiesterase 5 Inhibitors
Survival
Disease Progression
Arterial Pressure
Lung

Keywords

  • Hypertension
  • Magnetic resonance imaging
  • Pulmonary
  • Right ventricle

ASJC Scopus subject areas

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

Cite this

Changes in right ventricular function measured by cardiac magnetic resonance imaging in patients receiving pulmonary arterial hypertension-targeted therapy the EURO-MR study. / Peacock, Andrew J.; Crawley, Stephen; McLure, Lindsey; Blyth, Kevin; Vizza, Carmine Dario; Poscia, Roberto; Francone, Marco; Iacucci, Ilaria; Olschewski, Horst; Kovacs, Gabor; Vonk Noordegraaf, Anton; Marcus, J. Tim; Van De Veerdonk, Marielle C.; Oosterveer, Frank P T.

In: Circulation: Cardiovascular Imaging, Vol. 7, No. 1, 2014, p. 107-114.

Research output: Contribution to journalArticle

Peacock, AJ, Crawley, S, McLure, L, Blyth, K, Vizza, CD, Poscia, R, Francone, M, Iacucci, I, Olschewski, H, Kovacs, G, Vonk Noordegraaf, A, Marcus, JT, Van De Veerdonk, MC & Oosterveer, FPT 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, vol. 7, no. 1, pp. 107-114. https://doi.org/10.1161/CIRCIMAGING.113.000629
Peacock, Andrew J. ; Crawley, Stephen ; McLure, Lindsey ; Blyth, Kevin ; Vizza, Carmine Dario ; Poscia, Roberto ; Francone, Marco ; Iacucci, Ilaria ; Olschewski, Horst ; Kovacs, Gabor ; Vonk Noordegraaf, Anton ; Marcus, J. Tim ; Van De Veerdonk, Marielle C. ; Oosterveer, Frank P T. / Changes in right ventricular function measured by cardiac magnetic resonance imaging in patients receiving pulmonary arterial hypertension-targeted therapy the EURO-MR study. In: Circulation: Cardiovascular Imaging. 2014 ; Vol. 7, No. 1. pp. 107-114.
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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.",
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AU - Peacock, Andrew J.

AU - Crawley, Stephen

AU - McLure, Lindsey

AU - Blyth, Kevin

AU - Vizza, Carmine Dario

AU - Poscia, Roberto

AU - Francone, Marco

AU - Iacucci, Ilaria

AU - Olschewski, Horst

AU - Kovacs, Gabor

AU - Vonk Noordegraaf, Anton

AU - Marcus, J. Tim

AU - Van De Veerdonk, Marielle C.

AU - Oosterveer, Frank P T

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

KW - Hypertension

KW - Magnetic resonance imaging

KW - Pulmonary

KW - Right ventricle

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