Key result
A percentage-predicted right ventricular end-systolic volume index threshold of <227% identified 63% of patients as being at low risk (4.3%) of 1-year mortality, improving risk stratification in pulmonary arterial hypertension.
Why the study?
PAH is a life-shortening condition, and it was unknown whether cardiac MRI thresholds could aid risk stratification and facilitate decision-making alongside established risk calculators.
Do cardiac MRI thresholds accurately predict 1-year mortality risk in patients with pulmonary arterial hypertension?
Cohort (n=438)
Image analysis was performed by operators blinded to diagnosis and cardiac catheter result
No
Do cardiac MRI thresholds accurately predict 1-year mortality risk in patients with pulmonary arterial hypertension?
Absolute Event Rate: 4.3% vs 15%
p-value: p=<0.001
Cardiac MRI thresholds, particularly percentage-predicted right ventricular end-systolic volume index, can effectively stratify 1-year mortality risk in patients with pulmonary arterial hypertension and improve existing risk calculators.
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Cardiac MRI thresholds may aid PAH risk stratification alongside REVEAL 2.0; leaves open prospective validation before clinical adoption.
Lewis et al. (2019) conducted a cohort in Pulmonary arterial hypertension (n=438). Percentage-predicted right ventricular end-systolic volume index (RVESVi) <227% vs. RVESVi ≥227% was evaluated on 1-year mortality (p=<0.001). A percentage-predicted right ventricular end-systolic volume index threshold of <227% identified 63% of patients as being at low risk (4.3%) of 1-year mortality, improving risk stratification in pulmonary arterial hypertension.
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