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Erschienen in: The International Journal of Cardiovascular Imaging 7/2016

13.04.2016 | Original Paper

Right atrial emptying fraction non-invasively predicts mortality in pulmonary hypertension

verfasst von: Konstadina Darsaklis, Matthew E. Dickson, William Cornwell III, Colby R. Ayers, Fernando Torres, Kelly M. Chin, Susan Matulevicius

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 7/2016

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Abstract

Right-sided heart failure is the most common cause of death in pulmonary hypertension (PH). Echocardiographic measurements of right atrial (RA) size are associated with worse outcome in PH, however the association between RA function and death in PH has not been well-described. 160 PH patients (World Health Organization groups 1–5) underwent cardiac magnetic resonance imaging (cMRI) and right heart catheterization (RHC) within 6 weeks of each other at a tertiary care academic medical center in the United States. We measured cMRI RA maximum and minimum volumes indexed to body surface area and calculated RA emptying fraction (RAEF). We evaluated the relationship between RAEF and clinical variables with death using Cox proportional hazard models. 57 deaths occurred during a median follow-up of 3.5 years (36 % died overall, 10 % per year). RAEF was directly correlated in univariate analyses with right ventricular (RV) ejection fraction, left ventricular (LV) ejection fraction, LV size, cardiac index, absence of tricuspid and pulmonic regurgitation, absence of pericardial effusion, estimated glomerular filtration rate, 6-minute walk distance, and pulmonary arterial oxygen saturation, whereas it was inversely correlated with death, BNP, heart rate, mean RA pressure, mean PA pressure, pulmonary and systemic vascular resistance, RV size, and RA size. Using multivariate analyses, RAEF had a robust inverse association with death after adjusting for measured risk factors (HR per 5 % change in RAEF: 0.83 [95 % CI 0.73–0.94], p = 0.003). In PH patients, decreased RAEF by cMRI is independently associated with worse survival after adjustment for other risk factors.
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Metadaten
Titel
Right atrial emptying fraction non-invasively predicts mortality in pulmonary hypertension
verfasst von
Konstadina Darsaklis
Matthew E. Dickson
William Cornwell III
Colby R. Ayers
Fernando Torres
Kelly M. Chin
Susan Matulevicius
Publikationsdatum
13.04.2016
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 7/2016
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-016-0883-3

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