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Increased right atr...
Increased right atrial volume measured with cardiac magnetic resonance is associated with worse clinical outcome in patients with pre-capillary pulmonary hypertension
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- Bredfelt, Anna (författare)
- Skåne University Hospital,Lund University
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- Rådegran, Göran (författare)
- Lund University,Lunds universitet,Hjärt-lungsjukdom - information, stöd och bemötande,Forskargrupper vid Lunds universitet,Cardiopulmonary disease - information, support and reception,Lund University Research Groups,Skåne University Hospital
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- Hesselstrand, Roger (författare)
- Lund University,Lunds universitet,Hjärt-lungsjukdom - information, stöd och bemötande,Forskargrupper vid Lunds universitet,Cardiopulmonary disease - information, support and reception,Lund University Research Groups,Skåne University Hospital
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- Arheden, Håkan (författare)
- Lund University,Lunds universitet,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Lund Cardiac MR Group,Lund University Research Groups,Skåne University Hospital
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- Ostenfeld, Ellen (författare)
- Lund University,Lunds universitet,Hjärt-MR-gruppen i Lund,Forskargrupper vid Lunds universitet,Lund Cardiac MR Group,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- 2018-06-19
- 2018
- Engelska 12 s.
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Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 5:5, s. 864-875
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://onlinelibrar...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Aims: Pre-capillary pulmonary hypertension (PHpre-cap) has a poor prognosis, especially when caused by pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc-PAH). Whether cardiac magnetic resonance (CMR)-based quantification of atrial volumes in PHpre-cap is beneficial in risk assessment is unknown. The aims were to investigate if (i) atrial volumes using CMR are associated with death or lung transplantation in PHpre-cap, (ii) atrial volumes differ among four unmatched major PHpre-cap subgroups, and (iii) atrial volumes differ between SSc-PAH and idiopathic/familial PAH (IPAH/FPAH) when matched for pulmonary vascular resistance (PVR). Methods and results: Seventy-five PHpre-cap patients (57 ± 19 years, 53 female, 43 de novo) with CMR and right heart catheterization were retrospectively included. Short-axis stacks of cine images were analysed, and right and left atrial maximum (RAVmax and LAVmax) and minimum volume (RAVmin and LAVmin) were indexed for body surface area. Increased (mean + 2 SD) and reduced (mean – 2 SD) volumes were predefined from CMR normal values. Transplantation-free survival was lower in patients with increased RAVmax than in those with normal [hazard ratio (HR) = 2.1, 95% confidence interval (CI) 1.1–4.0] but did not differ between those with reduced LAVmax and normal (HR 2.0, 95% CI 0.8–5.1). RAVmax and RAVmin showed no differences among unmatched or matched groups (P = ns). When matched for PVR, LAVmax, LAVmin, and pulmonary artery wedge pressure were reduced in SSc-PAH compared with IPAH/FPAH (95% CI 0.3–21.4, 95% CI 0.8–19.6, and 95% CI 2–7, respectively). Conclusions: Patients with PHpre-cap and increased right atrial volume measured with CMR had worse clinical outcome. When matched for PVR, left atrial volume was lower in SSc-PAH than in IPAH/FPAH, consistent with left-sided underfilling, indicating a potential differentiator between the groups.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
Nyckelord
- Cardiac magnetic resonance imaging
- Left atrial volume
- Pulmonary hypertension
- Right atrial volume
- Transplantation-free survival
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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