The right heart in heart failure with preserved ejection fraction: insights from cardiac magnetic resonance imaging and invasive haemodynamics
Aims Recent data indicate that right ventricular systolic dysfunction (RVSD) by cardiac magnetic resonance imaging (CMR) is a strong predictor of outcome in heart failure. However, the prognostic significance of RVSD by CMR in heart failure with preserved ejection fraction (HFpEF) is unknown. Method...
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| Veröffentlicht in: | European journal of heart failure 2016-01, Vol.18 (1), p.71-80 |
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| creator | Aschauer, Stefan Kammerlander, Andreas A. Zotter-Tufaro, Caroline Ristl, Robin Pfaffenberger, Stefan Bachmann, Alina Duca, Franz Marzluf, Beatrice A. Bonderman, Diana Mascherbauer, Julia |
| description | Aims
Recent data indicate that right ventricular systolic dysfunction (RVSD) by cardiac magnetic resonance imaging (CMR) is a strong predictor of outcome in heart failure. However, the prognostic significance of RVSD by CMR in heart failure with preserved ejection fraction (HFpEF) is unknown.
Methods and results
We prospectively enrolled 171 HFpEF patients who underwent CMR in addition to invasive and non‐invasive testing. RVSD, defined as right ventricular (RV) EF |
| doi_str_mv | 10.1002/ejhf.418 |
| format | Article |
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Recent data indicate that right ventricular systolic dysfunction (RVSD) by cardiac magnetic resonance imaging (CMR) is a strong predictor of outcome in heart failure. However, the prognostic significance of RVSD by CMR in heart failure with preserved ejection fraction (HFpEF) is unknown.
Methods and results
We prospectively enrolled 171 HFpEF patients who underwent CMR in addition to invasive and non‐invasive testing. RVSD, defined as right ventricular (RV) EF <45% by CMR, was present in 33 (19.3 %) patients. Patients were followed for 573 ± 387 days, during which 41 had a cardiac event. Patients with RVSD presented with more frequent history of AF (P = 0.038), significantly higher resting heart rate (P = 0.009), shorter 6‐min walk distance (P = 0.036), and higher NT‐pro BNP serum levels (P < 0.001), and were more symptomatic (P < 0.001). With respect to haemodynamic parameters, RVSD was associated with respect to haemodynamic parameters, RVSD was associated with higher diastolic pulmonary artery pressure (P = 0.045), with higher pulmonary vascular resistance (P = 0.048), higher transpulmonary gradient (P = 0.042), and higher diastolic pulmonary vascular pressure gradient (P = 0.007). In the multivariable Cox analysis, RVSD (P < 0.001) remained significantly associated with cardiac events, in addition to diabetes (P = 0.011), 6‐min walk distance (P = 0.018), and systolic pulmonary artery pressure (P = 0.003).
Conclusions
Although HFpEF is considered a disease of the left ventricle, respective imaging parameters are not related to outcome. In contrast, RVSD by CMR is independently associated with mortality and clinical status in these patients, and provides a useful tool for risk stratification.</description><identifier>ISSN: 1388-9842</identifier><identifier>EISSN: 1879-0844</identifier><identifier>DOI: 10.1002/ejhf.418</identifier><identifier>PMID: 26449727</identifier><language>eng</language><publisher>Oxford, UK: John Wiley & Sons, Ltd</publisher><subject>Aged ; Austria - epidemiology ; Cardiac Catheterization - methods ; Cardiac magnetic resonance imaging ; Diabetes Mellitus - epidemiology ; Female ; Heart Failure - diagnosis ; Heart Failure - epidemiology ; Heart Failure - physiopathology ; Hemodynamics ; Humans ; Hypertension, Pulmonary - epidemiology ; Kaplan-Meier Estimate ; Magnetic Resonance Imaging, Cine - methods ; Male ; Middle Aged ; Natriuretic Peptide, Brain - analysis ; Outcome ; Peptide Fragments - analysis ; Prognosis ; Right ventricle ; Risk Assessment - methods ; Risk Factors ; Stroke Volume ; Ventricular Dysfunction, Right - diagnosis ; Ventricular Dysfunction, Right - epidemiology ; Ventricular Dysfunction, Right - physiopathology ; Ventricular Function, Left</subject><ispartof>European journal of heart failure, 2016-01, Vol.18 (1), p.71-80</ispartof><rights>2015 The Authors © 2015 European Society of Cardiology</rights><rights>2015 The Authors European Journal of Heart Failure © 2015 European Society of Cardiology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4638-3fe4e1582f3f608935e1c65c832f3149af6e823b0d52e14b98a6d5c834e979ed3</citedby><cites>FETCH-LOGICAL-c4638-3fe4e1582f3f608935e1c65c832f3149af6e823b0d52e14b98a6d5c834e979ed3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fejhf.418$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fejhf.418$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26449727$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aschauer, Stefan</creatorcontrib><creatorcontrib>Kammerlander, Andreas A.</creatorcontrib><creatorcontrib>Zotter-Tufaro, Caroline</creatorcontrib><creatorcontrib>Ristl, Robin</creatorcontrib><creatorcontrib>Pfaffenberger, Stefan</creatorcontrib><creatorcontrib>Bachmann, Alina</creatorcontrib><creatorcontrib>Duca, Franz</creatorcontrib><creatorcontrib>Marzluf, Beatrice A.</creatorcontrib><creatorcontrib>Bonderman, Diana</creatorcontrib><creatorcontrib>Mascherbauer, Julia</creatorcontrib><title>The right heart in heart failure with preserved ejection fraction: insights from cardiac magnetic resonance imaging and invasive haemodynamics</title><title>European journal of heart failure</title><addtitle>Eur J Heart Fail</addtitle><description>Aims
Recent data indicate that right ventricular systolic dysfunction (RVSD) by cardiac magnetic resonance imaging (CMR) is a strong predictor of outcome in heart failure. However, the prognostic significance of RVSD by CMR in heart failure with preserved ejection fraction (HFpEF) is unknown.
Methods and results
We prospectively enrolled 171 HFpEF patients who underwent CMR in addition to invasive and non‐invasive testing. RVSD, defined as right ventricular (RV) EF <45% by CMR, was present in 33 (19.3 %) patients. Patients were followed for 573 ± 387 days, during which 41 had a cardiac event. Patients with RVSD presented with more frequent history of AF (P = 0.038), significantly higher resting heart rate (P = 0.009), shorter 6‐min walk distance (P = 0.036), and higher NT‐pro BNP serum levels (P < 0.001), and were more symptomatic (P < 0.001). With respect to haemodynamic parameters, RVSD was associated with respect to haemodynamic parameters, RVSD was associated with higher diastolic pulmonary artery pressure (P = 0.045), with higher pulmonary vascular resistance (P = 0.048), higher transpulmonary gradient (P = 0.042), and higher diastolic pulmonary vascular pressure gradient (P = 0.007). In the multivariable Cox analysis, RVSD (P < 0.001) remained significantly associated with cardiac events, in addition to diabetes (P = 0.011), 6‐min walk distance (P = 0.018), and systolic pulmonary artery pressure (P = 0.003).
Conclusions
Although HFpEF is considered a disease of the left ventricle, respective imaging parameters are not related to outcome. In contrast, RVSD by CMR is independently associated with mortality and clinical status in these patients, and provides a useful tool for risk stratification.</description><subject>Aged</subject><subject>Austria - epidemiology</subject><subject>Cardiac Catheterization - methods</subject><subject>Cardiac magnetic resonance imaging</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Female</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Failure - physiopathology</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - epidemiology</subject><subject>Kaplan-Meier Estimate</subject><subject>Magnetic Resonance Imaging, Cine - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - analysis</subject><subject>Outcome</subject><subject>Peptide Fragments - analysis</subject><subject>Prognosis</subject><subject>Right ventricle</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Stroke Volume</subject><subject>Ventricular Dysfunction, Right - diagnosis</subject><subject>Ventricular Dysfunction, Right - epidemiology</subject><subject>Ventricular Dysfunction, Right - physiopathology</subject><subject>Ventricular Function, Left</subject><issn>1388-9842</issn><issn>1879-0844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMFOGzEYhK2qVaEUqU9Q-djLUnvtXdvc2kCgFYILFRIXy_H-zjrseoO9CeQl-sx1mpSeOHk0_makfxD6RMkJJaT8CovWnXAq36BDKoUqiOT8bdZMykJJXh6gDyktCKEi0-_RQVlzrkQpDtHv2xZw9PN2xC2YOGIf9sIZ360i4Cc_tngZIUFcQ4NhAXb0Q8Aumr_iNEfStiBla-ixNbHxxuLezAOM3uIcHYIJFrDPng9zbEKTQ2uT_Bpwa6Afmk0wvbfpI3rnTJfgeP8eoV_T89vJZXF1c_Fj8u2qsLxmsmAOONBKlo65mkjFKqC2rqxk2aFcGVeDLNmMNFUJlM-UNHWz_eaghIKGHaEvu95lHB5XkEbd-2Sh60yAYZU0FblWVFLR_6iNQ0oRnF7GfEjcaEr0dn29XV_n9TP6ed-6mvXQvID_5s5AsQOefAebV4v0-c_L6a5wz_s0wvMLb-KDrgUTlb67vtD31_dn36eK6wn7AxDioHU</recordid><startdate>201601</startdate><enddate>201601</enddate><creator>Aschauer, Stefan</creator><creator>Kammerlander, Andreas A.</creator><creator>Zotter-Tufaro, Caroline</creator><creator>Ristl, Robin</creator><creator>Pfaffenberger, Stefan</creator><creator>Bachmann, Alina</creator><creator>Duca, Franz</creator><creator>Marzluf, Beatrice A.</creator><creator>Bonderman, Diana</creator><creator>Mascherbauer, Julia</creator><general>John Wiley & Sons, Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201601</creationdate><title>The right heart in heart failure with preserved ejection fraction: insights from cardiac magnetic resonance imaging and invasive haemodynamics</title><author>Aschauer, Stefan ; Kammerlander, Andreas A. ; Zotter-Tufaro, Caroline ; Ristl, Robin ; Pfaffenberger, Stefan ; Bachmann, Alina ; Duca, Franz ; Marzluf, Beatrice A. ; Bonderman, Diana ; Mascherbauer, Julia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4638-3fe4e1582f3f608935e1c65c832f3149af6e823b0d52e14b98a6d5c834e979ed3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Austria - epidemiology</topic><topic>Cardiac Catheterization - methods</topic><topic>Cardiac magnetic resonance imaging</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Female</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Failure - physiopathology</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - epidemiology</topic><topic>Kaplan-Meier Estimate</topic><topic>Magnetic Resonance Imaging, Cine - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - analysis</topic><topic>Outcome</topic><topic>Peptide Fragments - analysis</topic><topic>Prognosis</topic><topic>Right ventricle</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Stroke Volume</topic><topic>Ventricular Dysfunction, Right - diagnosis</topic><topic>Ventricular Dysfunction, Right - epidemiology</topic><topic>Ventricular Dysfunction, Right - physiopathology</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aschauer, Stefan</creatorcontrib><creatorcontrib>Kammerlander, Andreas A.</creatorcontrib><creatorcontrib>Zotter-Tufaro, Caroline</creatorcontrib><creatorcontrib>Ristl, Robin</creatorcontrib><creatorcontrib>Pfaffenberger, Stefan</creatorcontrib><creatorcontrib>Bachmann, Alina</creatorcontrib><creatorcontrib>Duca, Franz</creatorcontrib><creatorcontrib>Marzluf, Beatrice A.</creatorcontrib><creatorcontrib>Bonderman, Diana</creatorcontrib><creatorcontrib>Mascherbauer, Julia</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aschauer, Stefan</au><au>Kammerlander, Andreas A.</au><au>Zotter-Tufaro, Caroline</au><au>Ristl, Robin</au><au>Pfaffenberger, Stefan</au><au>Bachmann, Alina</au><au>Duca, Franz</au><au>Marzluf, Beatrice A.</au><au>Bonderman, Diana</au><au>Mascherbauer, Julia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The right heart in heart failure with preserved ejection fraction: insights from cardiac magnetic resonance imaging and invasive haemodynamics</atitle><jtitle>European journal of heart failure</jtitle><addtitle>Eur J Heart Fail</addtitle><date>2016-01</date><risdate>2016</risdate><volume>18</volume><issue>1</issue><spage>71</spage><epage>80</epage><pages>71-80</pages><issn>1388-9842</issn><eissn>1879-0844</eissn><abstract>Aims
Recent data indicate that right ventricular systolic dysfunction (RVSD) by cardiac magnetic resonance imaging (CMR) is a strong predictor of outcome in heart failure. However, the prognostic significance of RVSD by CMR in heart failure with preserved ejection fraction (HFpEF) is unknown.
Methods and results
We prospectively enrolled 171 HFpEF patients who underwent CMR in addition to invasive and non‐invasive testing. RVSD, defined as right ventricular (RV) EF <45% by CMR, was present in 33 (19.3 %) patients. Patients were followed for 573 ± 387 days, during which 41 had a cardiac event. Patients with RVSD presented with more frequent history of AF (P = 0.038), significantly higher resting heart rate (P = 0.009), shorter 6‐min walk distance (P = 0.036), and higher NT‐pro BNP serum levels (P < 0.001), and were more symptomatic (P < 0.001). With respect to haemodynamic parameters, RVSD was associated with respect to haemodynamic parameters, RVSD was associated with higher diastolic pulmonary artery pressure (P = 0.045), with higher pulmonary vascular resistance (P = 0.048), higher transpulmonary gradient (P = 0.042), and higher diastolic pulmonary vascular pressure gradient (P = 0.007). In the multivariable Cox analysis, RVSD (P < 0.001) remained significantly associated with cardiac events, in addition to diabetes (P = 0.011), 6‐min walk distance (P = 0.018), and systolic pulmonary artery pressure (P = 0.003).
Conclusions
Although HFpEF is considered a disease of the left ventricle, respective imaging parameters are not related to outcome. In contrast, RVSD by CMR is independently associated with mortality and clinical status in these patients, and provides a useful tool for risk stratification.</abstract><cop>Oxford, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>26449727</pmid><doi>10.1002/ejhf.418</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | Wiley Free Content; MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Austria - epidemiology Cardiac Catheterization - methods Cardiac magnetic resonance imaging Diabetes Mellitus - epidemiology Female Heart Failure - diagnosis Heart Failure - epidemiology Heart Failure - physiopathology Hemodynamics Humans Hypertension, Pulmonary - epidemiology Kaplan-Meier Estimate Magnetic Resonance Imaging, Cine - methods Male Middle Aged Natriuretic Peptide, Brain - analysis Outcome Peptide Fragments - analysis Prognosis Right ventricle Risk Assessment - methods Risk Factors Stroke Volume Ventricular Dysfunction, Right - diagnosis Ventricular Dysfunction, Right - epidemiology Ventricular Dysfunction, Right - physiopathology Ventricular Function, Left |
| title | The right heart in heart failure with preserved ejection fraction: insights from cardiac magnetic resonance imaging and invasive haemodynamics |
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