Abstract 1976: Stress CMR Predicts Future Cardiac Function and Cardiac Events in Patients With a Systemic Right Ventricle
Purpose: The prognostic value of stress Cardiovascular Magnetic Resonance (CMR) Imaging for future cardiac function and events is unknown in patients with a systemic right ventricle (RV). Therefore, the aim of our study was to evaluate the prognostic value of stress CMR in these patients.
Methods: Thirty-nine patients (54% male; age 26±8 years) with a systemic RV underwent stress CMR in 1999/2000, and rest CMR after a mean follow-up period of 6±2 years. We evaluated the prognostic value of systemic RV response to stress on future systemic RV volumes and function, and on future cardiac events (defined as hospitalization for heart failure, cardiac surgery or death).
Results: At baseline, systemic RV end diastolic (ED) and end systolic (ES) volumes decreased significantly during stress (−12±27 ml; p=0.01 and −8±18 ml; p=0.01, respectively), whereas ejection-fraction (EF) increased (3±8%; p=0.05). During follow-up, ED and ES volumes increased (74±42 ml; p<0.001 and 60±35ml; p<0.001, respectively), and RV EF decreased significantly (−12±10%; p<0.001). The inability to decrease ED and ES volumes during stress was significantly associated with a more rapid increase of volumes over time. Cardiac events were observed in 8% of patients who could increase RV EF during stress, compared to 40% in those who could not increase RV EF during stress (hazard ratio 5.8; 95% confidence interval 1.2–28.7; p=0.02). Figure 1⇓.
Conclusions: Overall, adult patients with a systemic RV are subject to rapid deterioration of RV function over time. Stress CMR is highly useful in this patient group, as it is an independent predictor of future cardiac events.