Related Experiment Video
Updated: May 23, 2025
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Cardiac MRI optimizes risk stratification accuracy in connective tissue disease-associated pulmonary arterial
Yue Zhang1, Xiaohui Wang1, Xiaoxuan Sun2
1Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Insights
Cardiovascular magnetic resonance (CMR) parameters, specifically right ventricular ejection fraction (RVEF) and interventricular septum extracellular volume (IVS ECV), significantly improve prognostic accuracy for connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH) patients.
Area of Science:
- Cardiology
- Radiology
- Pulmonology
Background:
- Connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH) requires accurate prognostic evaluation.
- Current risk assessment models may benefit from enhanced predictive parameters.
Purpose of the Study:
- To evaluate the utility of cardiovascular magnetic resonance (CMR) parameters in predicting clinical deterioration in CTD-PAH patients.
- To determine if CMR metrics can augment existing risk assessment models.
Main Methods:
- Retrospective cohort study of 110 CTD-PAH patients diagnosed via right heart catheterization.
- Analysis of CMR parameters and their correlation with clinical deterioration events over a mean follow-up of 27 months.
Main Results:
- Five CMR metrics were identified as independent risk factors for clinical deterioration.
- Integration of right ventricular ejection fraction (RVEF) and interventricular septum extracellular volume (IVS ECV) with the COMPERA 2.0 model significantly improved predictive accuracy (C-index improved from 0.626 to 0.805).
- Specific thresholds for RVEF (<39.2%) and IVS ECV (>31.4%) indicated poorer prognosis.
Conclusions:
- Combining RVEF and IVS ECV with the COMPERA 2.0 risk assessment model substantially enhances its predictive capability for clinical deterioration in CTD-PAH.
- CMR parameters offer valuable prognostic information for CTD-PAH management.
Objectives:
The primary objective of this study is to investigate the potential of cardiac magnetic resonance (CMR) parameters to augment prognostic evaluation in patients with CTD-associated pulmonary arterial hypertension (CTD-PAH).
Methods:
A retrospective, single-centre cohort study was conducted on 110 patients with CTD-PAH who were diagnosed via right heart catheterization between 2017 and 2023. These patients underwent CMR examinations based on clinical indications.
Results:
After a mean follow-up period of 27 months, 27 patients experienced clinical deterioration events. After adjusting for age, sex and COMPERA 2.0 risk assessment model parameters, five CMR metrics were identified as independent risk factors for clinical deterioration in CTD-PAH patients. Receiver operating characteristic curve analysis showed that combining COMPERA 2.0 risk assessment model with CMR metrics improved predictive performance, with interventricular septum extracellular volume (IVS ECV) providing the greatest benefit among tissue metrics and right ventricular ejection fraction (RVEF) showing the most improvement among right heart function metrics. Kaplan-Meier（KM） survival curves revealed that patients with RVEF <39.2% and IVS ECV >31.4% had the poorest prognosis. Calibration curves indicated that integrating RVEF and IVS ECV significantly enhanced the accuracy and reliability of the COMPERA 2.0 risk assessment model in predicting 1-, 2- and 3-year event-free survival rates in CTD-PAH patients, with the C-index improving from 0.626 to 0.805.
Conclusion:
Combining RVEF and IVS ECV with COMPERA 2.0 risk assessment model significantly enhances the model's predictive accuracy for clinical deterioration in CTD-PAH patients.
More Related Videos
12:15Tissue Preparation Techniques for Contrast-Enhanced Micro Computed Tomography Imaging of Large Mammalian Cardiac Models with Chronic Disease
Published on: February 8, 2022
08:10Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
