Abstract 12309: Prediction of Adverse Events Using Myocardial Fibrosis in Right Ventricle on ECG Gated 320 Slice CT in Subjects With Pulmonary Hypertension. A Study With a Median of 18 Months Follow-Up
Purpose: To predict occurrence of adverse events (AE) in subjects with pulmonary hypertension (PH), we evaluated presence of myocardial fibrosis (MF), as represented by abnormal late enhancement on CT, in right ventricle (RV), detected on ECG gated enhanced 320 slice CT.
Materials and Methods: A total of 56 PH subjects confirmed on right heart catheterization (RHC) (15 males, 57 ± 15 years, 33 chronic thromboembolic PH (CTEPH), 21 pulmonary arterial hypertension (PAH), and 2 others) underwent ECG gated 320 slice CT (Aquilion one) to evaluate pulmonary artery, RHC and transthoracic echocardiogram (TTE) within 3 months without any clinical incident. Prospective ECG gating was added and if there was abnormal enhancement in RV myocardium, we regarded this as MF. Subjects were followed for a median of 18 months.
Results: AE occurred in 11 subjects (5 males, 60 ± 10 years); cardiac death (3), heart failure (6), cerebral hemorrhage (2). MF in RV was detected in 16 subjects (5 males, 56 ± 12 years, 9 CTEPH, 6 PAH and 1 other). Comparing subjects with and without MF, only cardiac output (l/min) calculated on TTE was significantly lower in subject with than without MF (P ≤ 0.05). However, there were no significant differences between groups in other factors, especially hemodynamic state parameters, on CT, TTE and RHC. Significant differences between subjects with and without MF were seen at each time point when whole follow up period was compared by further Kaplan Meier analysis and log rank test (P = 0.033).
Conclusion: Presence of MF in RV detected on ECG gated 320 slice CT may have a short term poor prognosis in PH subjects, even though there were no significant differences in hemodynamic state parameters acquired from CT, TTE and RHC (except cardiac output) on TTE between subjects with and without MF. In contrast to hemodynamic state parameters, which tend to change, presence of MF in RV is a permanent morphological parameter which may be useful for accurately predicting prognosis of PH subjects.
- © 2013 by American Heart Association, Inc.