Abstract 12510: Volume of Myocardial Delayed Contrast Enhancement is a Strong Predictor of Cardiac Outcomes in Patients with Pulmonary Hypertension
Background: Delayed myocardial enhancement (DE) on cardiac magnetic resonance (CMR) in patients with pulmonary hypertension (PH) correlates with disease severity and right ventricular (RV) systolic function. However, the correlation of DE with overall prognosis is unknown.
Hypothesis: We hypothesized that the DE volume on CMR correlates with cardiovascular events in patients with PH.
Methods: CMR was performed using a 1.5T MR system on 26 consecutive PH patients (15 idiopathic PH, 11 chronic thromboembolic PH; CTEPH) within 1 week following cardiac catheterization. A multi-slice, breath-hold, inversion recovery true-FISP sequence was performed 20 min after Gadolinium injection. Pulmonary arterial pressure (PAP), pulmonary vascular resistance index (PVRI), and cardiac index (CI) were measured by cardiac catheterization. Univariate and multivariate Cox regression analyses were used to identify predictors of cardiac events defined as death or heart failure.
Results: DE was seen in all patients at the insertion point of the RV to the interventricular septum. The mean DE volume was 12±7 cm3. By univariate analysis, mean PAP, PVRI, left ventricular (LV) EF, and DE volume significantly correlated with cardiovascular events during the follow-up period (mean: 24±11 months). By multivariate analysis with the co-factors listed above, only the DE volume significantly correlated with poor prognosis (see table).
Conclusion: The DE volume assessed by CMR strongly correlated with cardiovascular events in patients with pulmonary hypertension.
- © 2010 by American Heart Association, Inc.