Duration of interventricular septal shift toward the left ventricle is associated with poor clinical outcome in precapillary pulmonary hypertension: A cardiac magnetic resonance study
Background: Right ventricular pressure overload results in interventricular septal shift toward the left ventricle in patients with precapillary pulmonary hypertension (PH). We aimed to investigate the predictive role of the duration of septal curvature configuration during the cardiac cycle, as exp...
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doaj-91842024b384473f9ec9874a24067f892020-11-25T03:25:28ZengElsevierHellenic Journal of Cardiology1109-96662020-03-01612112117Duration of interventricular septal shift toward the left ventricle is associated with poor clinical outcome in precapillary pulmonary hypertension: A cardiac magnetic resonance studySophia Anastasia Mouratoglou0Alexandros Kallifatidis1Georgia Pitsiou2Vasileios Grosomanidis3Vasileios Kamperidis4Georgios Chalikias5Diana Kristo6Dimitrios Tziakas7Stavros Konstantinides8Stavros Hadjimiltiades9Haralambos Karvounis10George Giannakoulas11First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, GreeceDepartment of Radiology, St. Luke Hospital of Thessaloniki, Thessaloniki, GreeceRespiratory Failure Unit, Aristotle University of Thessaloniki, Thessaloniki, GreeceDepartment of Anesthesiology and Intensive Care Medicine, AHEPA University Hospital, Aristotle University, Thessaloniki, GreeceFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, GreeceUniversity Cardiology Department, Medical School, Democritus University of Thrace, Alexandroupolis, GreeceFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, GreeceUniversity Cardiology Department, Medical School, Democritus University of Thrace, Alexandroupolis, GreeceUniversity Cardiology Department, Medical School, Democritus University of Thrace, Alexandroupolis, GreeceFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, GreeceFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, GreeceFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; Corresponding author. 1st Department of Cardiology AHEPA University Hospital St. Kiriakidi 1, 54636, Thessaloniki, Greece. Tel.: +30 2310994830, Fax: +30 2310994673.Background: Right ventricular pressure overload results in interventricular septal shift toward the left ventricle in patients with precapillary pulmonary hypertension (PH). We aimed to investigate the predictive role of the duration of septal curvature configuration during the cardiac cycle, as expressed by the novel marker curvature duration index (CDi) in precapillary PH. Methods: This was a prospective study. All patients underwent cardiac magnetic resonance (CMR). CDi was defined by the number of CMR frames in which septal curvature configuration toward left ventricle is observed *100/total number of frames per cardiac cycle. Time from enrollment to first clinical failure event (death, hospitalization due to PH, and disease progression) was recorded. Results: The study included 36 patients with precapillary PH. During a median follow-up of 20 months (IQR 4-37 months), 14 clinical failure events were observed. Survival ROC analysis showed that the optimal cutoff value of CDi, which predicted clinical failure, was 67%. Kaplan–Meier survival analysis showed that CDi≥67% was associated with a 9.4-fold increase in the risk for clinical failure. Addition of CDi to baseline models including six-minute walk test distance (c-statistic = 0.65 vs. c-statistic = 0.79), NT-proBNP (c-statistic = 0.72 vs. c-statistic = 0.83), and WHO functional class (c-statistic = 0.76 vs. c-statistic = 0.81) improved risk stratification. Conclusion: Ventricular septal shift toward the left ventricle lasting for more than the two thirds of the cardiac cycle is associated with worse prognosis in precapillary PH.http://www.sciencedirect.com/science/article/pii/S1109966618303671Pulmonary hypertensionCardiac magnetic resonance imagingSeptal shiftPrognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sophia Anastasia Mouratoglou Alexandros Kallifatidis Georgia Pitsiou Vasileios Grosomanidis Vasileios Kamperidis Georgios Chalikias Diana Kristo Dimitrios Tziakas Stavros Konstantinides Stavros Hadjimiltiades Haralambos Karvounis George Giannakoulas |
spellingShingle |
Sophia Anastasia Mouratoglou Alexandros Kallifatidis Georgia Pitsiou Vasileios Grosomanidis Vasileios Kamperidis Georgios Chalikias Diana Kristo Dimitrios Tziakas Stavros Konstantinides Stavros Hadjimiltiades Haralambos Karvounis George Giannakoulas Duration of interventricular septal shift toward the left ventricle is associated with poor clinical outcome in precapillary pulmonary hypertension: A cardiac magnetic resonance study Hellenic Journal of Cardiology Pulmonary hypertension Cardiac magnetic resonance imaging Septal shift Prognosis |
author_facet |
Sophia Anastasia Mouratoglou Alexandros Kallifatidis Georgia Pitsiou Vasileios Grosomanidis Vasileios Kamperidis Georgios Chalikias Diana Kristo Dimitrios Tziakas Stavros Konstantinides Stavros Hadjimiltiades Haralambos Karvounis George Giannakoulas |
author_sort |
Sophia Anastasia Mouratoglou |
title |
Duration of interventricular septal shift toward the left ventricle is associated with poor clinical outcome in precapillary pulmonary hypertension: A cardiac magnetic resonance study |
title_short |
Duration of interventricular septal shift toward the left ventricle is associated with poor clinical outcome in precapillary pulmonary hypertension: A cardiac magnetic resonance study |
title_full |
Duration of interventricular septal shift toward the left ventricle is associated with poor clinical outcome in precapillary pulmonary hypertension: A cardiac magnetic resonance study |
title_fullStr |
Duration of interventricular septal shift toward the left ventricle is associated with poor clinical outcome in precapillary pulmonary hypertension: A cardiac magnetic resonance study |
title_full_unstemmed |
Duration of interventricular septal shift toward the left ventricle is associated with poor clinical outcome in precapillary pulmonary hypertension: A cardiac magnetic resonance study |
title_sort |
duration of interventricular septal shift toward the left ventricle is associated with poor clinical outcome in precapillary pulmonary hypertension: a cardiac magnetic resonance study |
publisher |
Elsevier |
series |
Hellenic Journal of Cardiology |
issn |
1109-9666 |
publishDate |
2020-03-01 |
description |
Background: Right ventricular pressure overload results in interventricular septal shift toward the left ventricle in patients with precapillary pulmonary hypertension (PH). We aimed to investigate the predictive role of the duration of septal curvature configuration during the cardiac cycle, as expressed by the novel marker curvature duration index (CDi) in precapillary PH. Methods: This was a prospective study. All patients underwent cardiac magnetic resonance (CMR). CDi was defined by the number of CMR frames in which septal curvature configuration toward left ventricle is observed *100/total number of frames per cardiac cycle. Time from enrollment to first clinical failure event (death, hospitalization due to PH, and disease progression) was recorded. Results: The study included 36 patients with precapillary PH. During a median follow-up of 20 months (IQR 4-37 months), 14 clinical failure events were observed. Survival ROC analysis showed that the optimal cutoff value of CDi, which predicted clinical failure, was 67%. Kaplan–Meier survival analysis showed that CDi≥67% was associated with a 9.4-fold increase in the risk for clinical failure. Addition of CDi to baseline models including six-minute walk test distance (c-statistic = 0.65 vs. c-statistic = 0.79), NT-proBNP (c-statistic = 0.72 vs. c-statistic = 0.83), and WHO functional class (c-statistic = 0.76 vs. c-statistic = 0.81) improved risk stratification. Conclusion: Ventricular septal shift toward the left ventricle lasting for more than the two thirds of the cardiac cycle is associated with worse prognosis in precapillary PH. |
topic |
Pulmonary hypertension Cardiac magnetic resonance imaging Septal shift Prognosis |
url |
http://www.sciencedirect.com/science/article/pii/S1109966618303671 |
work_keys_str_mv |
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