RT Journal Article
SR Electronic
T1 Right ventricular MRI characteristics in patients with borderline pulmonary hypertension
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA1874
DO 10.1183/13993003.congress-2016.PA1874
VO 48
IS suppl 60
A1 Kieran Shotton
A1 Henry Walker
A1 Christopher Johns
A1 Dave Capener
A1 Charlie Elliot
A1 Robin Condliffe
A1 Thanos Charalampopoulos
A1 David Kiely
A1 Jim Wild
A1 Andrew Swift
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA1874.abstract
AB Pulmonary hypertension (PH) is defined as a mean pulmonary artery pressure (mPAP) ≥ 25mmHg at right heart catheterization. An mPAP of 21-24mmHg is termed borderline PH. This study investigates cardiac magnetic resonance (CMR) imaging characteristics of patients with borderline PH.Consecutive patients who underwent CMR at 1.5T at a PH centre between April 2012 and January 2016 were identified. Exclusion criteria were non-diagnostic imaging or RHC >48 hours from CMR. All variables were compared between patients with normal mPAP (≤ 20mmHg) and a borderline group (21-24 mmHg) using an independent samples t-test and bilogistic regression.Of 1800 consecutive patients with suspected PH, 128 patients met the inclusion criteria. In the full cohort, large RVEDVI (p<0.001), RVESVI (p<0.001), Interventricular septal (IVS) angle (p=0.003) and LA volume (p=0.014) were significantly higher in the borderline group. At bilogistic regression, borderline PH was independently associated with IVS angle and RVEDVI.Subgroup analysis of patients with connective tissue disease (N=49) revealed raised systolic IVS angle (p=0.048) in borderline patients (N=22). In patients with lung disease (N=60), borderline patients (N=32) had raised RVEDVI (p=0.001), RV mass index (p=0.028) and IVS angle (p=0.05). LHD patients (N=16) with borderline pressures (N=9) had raised RVEDVI (p=0.022) and RV mass index (p=0.041). Patients with thromboembolic disease (N=36) with borderline pressures (N=18) had raised RV mass index (p=0.026).Patients with borderline PH have evidence of RV remodelling but preserved RV functional metrics when compared to patients with normal PA pressure.