Key result
A pulmonary vascular resistance ≥5.2 Wood units estimated by cardiac magnetic resonance independently predicted readmission for heart failure or all-cause death (HR 4.27; 95% CI 1.75-10.42; P<0.001).
Why the study?
Does non-invasive estimation of pulmonary vascular resistance by cardiac magnetic resonance predict adverse events in patients with chronic heart failure?
Cohort (n=132)
Does non-invasive estimation of pulmonary vascular resistance by cardiac magnetic resonance predict adverse events in patients with chronic heart failure?
Hazard Ratio: 4.27 (95% CI 1.75–10.42)
p-value: p=<0.001
Non-invasive estimation of pulmonary vascular resistance by cardiac magnetic resonance provides significant prognostic value for predicting readmission or death in patients with chronic heart failure.
AIMS: Pulmonary arterial hypertension is known to be related to worse prognosis in patients with heart failure (HF). Quantification of pulmonary vascular resistance (PVR) still requires invasive right heart catheterization. Recent studies have shown an accurate method for non-invasive estimation of PVR by cardiac magnetic resonance (CMR). Our aim was to evaluate the prognostic value of PVR calculated by CMR in patients with congestive HF. METHODS AND RESULTS: We calculated PVR by CMR in 132 patients [age 65.6 ± 13.1 years, left ventricular ejection fraction (LVEF) 35.1 ± 16.4%, ischaemic aetiology 40%] recently admitted for decompensated HF and derived to our cardiac imaging unit for diagnosis. Patients with cardiac events (readmission for HF or all-cause death) had higher values of PVR [6.77 ± 1.9 vs. 4.1 ± 1.6 Wood units (Wu), P < 0.001] during follow-up [mean 10.3 (1-31) months]. In multivariable Cox regression analysis, only a PVR ≥5.2 Wu [hazard ratio (HR) 4.27; 95% confidence interval (CI) 1.75-10.42; P < 0.001) and the presence of late gadolinium enhancement (LGE) on CMR (HR 2.24; 95% CI 1.03-4.86; P = 0.04) were independent predictors for adverse events at follow-up. CONCLUSION: Non-invasive estimation of PVR by CMR might be useful for risk stratification of patients with chronic HF, irrespective of aetiology or LVEF.
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Fabregat‐Andrés et al. (2014) conducted a cohort in chronic heart failure (n=132). Pulmonary vascular resistance ≥5.2 Wood units estimated by CMR vs. Pulmonary vascular resistance <5.2 Wood units was evaluated on cardiac events (readmission for HF or all-cause death) (HR 4.27, 95% CI 1.75-10.42, p=<0.001). A pulmonary vascular resistance ≥5.2 Wood units estimated by cardiac magnetic resonance independently predicted readmission for heart failure or all-cause death (HR 4.27; 95% CI 1.75-10.42; P<0.001).
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