Abstract 13206: Study of Rv Remodeling in Idiopathic Pulmonary Arterial Hypertension With 3D Echo and Cardiac MRI
Background: The aim of the study was to assess RV remodeling in idiopathic pulmonary arterial hypertensive (IPAH) patients during a follow up of 2 years.
Methods: 30 IPAH patients (mean age: 46.2 ± 13 years) were followed up with conventional 2D echocardiography (2DE), real time 3D echo (3DE) and cardiac MRI (CMR) every 6 months. Six minute walk test distance in every follow up was also recorded. Data were expressed as mean ± standard deviation for normally distributed values and median ± interquartile change when variables were not-normally distributed. Agreement between 3DE and CMR was assessed with Bland-Altman agreement analysis.
Results: During the follow up of IPAH patients, there was an initial improvement of all 2DE indices after initiation of therapy and during the first 6 months of follow up, except right atrial volume which increased despite therapy. Six-minute walk distance initially decreased but after the second follow up it improved. RV volumes increased, after 1 year of follow up – as demonstrated with both 3DE and CMR (RV end-diastolic volume-3DE: mean: 168.7 ± 52.7 ml vs. 192.1 ± 51.5 ml (p<0.01)) and RVmass increased within one year, despite medical therapy (RVmass-3DE: mean: 92.4 ± 25.2 gr vs. 114.9 ± 29.3 gr (p<0.01)). There was significant agreement between 3DE and CMR for volumes and ejection fraction (RV end-diastolic volume-baseline: r=0.85, mean bias = −15 ml, SD of bias= 30 ml – RV ejection fraction: r = 0.8, mean bias = 0.9%, SD of bias = 7.2%) but not for RV mass (baseline: r= −0.27, p=0.14).
Conclusions: In IPAH patients, RV volumes dilate and ejection fraction decreases over time. 3DE and CMR have significant agreement for volumes and ejection fraction but there are important limitations for the measurement of RV mass.
- © 2010 by American Heart Association, Inc.