Novel measures of left ventricular electromechanical discoordination predict clinical outcomes in children with pulmonary arterial hypertension
Key result
Pediatric patients with pulmonary arterial hypertension had increased systolic stretch fraction compared with healthy controls (P=0.004), which was prognostic for worse clinical outcomes.
Why the study?
Adverse ventricle-ventricle interaction and resultant LV dysfunction progress disease in PAH, prompting investigation into the clinical and mechanistic implications of LV electromechanical dyssynchrony in children with PAH using novel CMR-derived discoordination indexes.
Do novel cardiac MRI-derived indices of left ventricular electromechanical discoordination predict clinical outcomes in children with pulmonary arterial hypertension?
Population
64 children with PAH referred for CMR and 20 healthy controls
Comparison
Children with PAH vs healthy controls
Design
Case-control study
Authors
Discussion
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Member takes
Implication
Does not support practice change in pediatric PAH; leaves open whether CMR discoordination indices improve risk stratification.
Study Design
Type
Case-Control (n=84)
Structured PICO
Do novel cardiac MRI-derived indices of left ventricular electromechanical discoordination predict clinical outcomes in children with pulmonary arterial hypertension?
P
Population
84 children, comprising 64 with pulmonary arterial hypertension referred for cardiac MRI and 20 healthy controls.
E
Exposure
Assessment of left ventricular electromechanical dyssynchrony using novel systolic stretch fraction (SSF) and diastolic relaxation fraction (DRF) derived noninvasively from cardiac MRI.
C
Comparator
Healthy controls (n=20).
O
Outcome
Composite clinical outcomes.composite
Main Result
p-value: p=0.004
Novel CMR-derived left ventricular discoordination indices (systolic stretch fraction and diastolic relaxation fraction) are altered in pediatric PAH and predict worse clinical outcomes.
Cite This Study
Frank et al. (2019) conducted a case-control in Pulmonary arterial hypertension (n=84). Pulmonary arterial hypertension vs. Healthy controls was evaluated on Systolic stretch fraction (SSF) (p=0.004). Pediatric patients with pulmonary arterial hypertension had increased systolic stretch fraction compared with healthy controls (P=0.004), which was prognostic for worse clinical outcomes.