Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Exercise cardiovascular magnetic resonance imaging allows differentiation of low-risk pulmonary arterial hypertension

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

APA

CBE

MLA

Vancouver

Author

Bibtex

@article{199bb55b947e4bbc9779decc2b318844,
title = "Exercise cardiovascular magnetic resonance imaging allows differentiation of low-risk pulmonary arterial hypertension",
abstract = "BACKGROUND: Patients with pulmonary arterial hypertension (PAH) have a decreased ability to compensate for demands on increased cardiac output, such as during exercise. In this study we aimed to differentiate cardiac exercise responses in patients with PAH, stratified according to known measurements of disease severity.METHODS: Right and left ventricular end-diastolic volume and end-systolic volume, stroke volume (SV), and cardiac output were measured in 20 patients with PAH and a lower risk of mortality with 6-month intervals using cardiovascular magnetic resonance (CMR) imaging during rest and during ergometer exercise (totaling 44 scans). Exercise measurements were compared with resting cardiac conditions and clinical assessment using mixed model statistics.RESULTS: SV response during exercise was associated with disease severity. World Health Organization functional class (WHO FC) I and right ventricular end-diastolic volume (RVEDV) <221 ml were associated with increased SV during exercise (WHO FC I: 7{\%} increase in SV; p < 0.001). In contrast, WHO FC II was associated with an 8{\%} decrease in SV (p = 0.02), and SV response declined progressively with right ventricular dilation (7-ml decrease in SV per 100-ml increase in RVEDV; p < 0.001).CONCLUSIONS: Assessment of right ventricular function with CMR during exercise stratifies patients currently perceived as having a low risk of mortality into different degrees of right ventricular inotropic reserve. Reduced SV during exercise is a plausible factor to increased risk of decompensation, possibly warranting targeted therapy intensification to restore right ventricular functional reserve.",
keywords = "cardiovascular magnetic resonance imaging, exercise, pulmonary arterial hypertension, right ventricular function, risk assessment, stroke volume",
author = "Christoffer G{\"o}ransson and Niels Vejlstrup and J{\o}rn Carlsen",
note = "Copyright {\circledC} 2019 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.",
year = "2019",
month = "6",
day = "1",
doi = "10.1016/j.healun.2019.01.1305",
language = "English",
volume = "38",
pages = "627--635",
journal = "Journal of Heart and Lung Transplantation",
issn = "1053-2498",
publisher = "Elsevier Inc",
number = "6",

}

RIS

TY - JOUR

T1 - Exercise cardiovascular magnetic resonance imaging allows differentiation of low-risk pulmonary arterial hypertension

AU - Göransson, Christoffer

AU - Vejlstrup, Niels

AU - Carlsen, Jørn

N1 - Copyright © 2019 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - BACKGROUND: Patients with pulmonary arterial hypertension (PAH) have a decreased ability to compensate for demands on increased cardiac output, such as during exercise. In this study we aimed to differentiate cardiac exercise responses in patients with PAH, stratified according to known measurements of disease severity.METHODS: Right and left ventricular end-diastolic volume and end-systolic volume, stroke volume (SV), and cardiac output were measured in 20 patients with PAH and a lower risk of mortality with 6-month intervals using cardiovascular magnetic resonance (CMR) imaging during rest and during ergometer exercise (totaling 44 scans). Exercise measurements were compared with resting cardiac conditions and clinical assessment using mixed model statistics.RESULTS: SV response during exercise was associated with disease severity. World Health Organization functional class (WHO FC) I and right ventricular end-diastolic volume (RVEDV) <221 ml were associated with increased SV during exercise (WHO FC I: 7% increase in SV; p < 0.001). In contrast, WHO FC II was associated with an 8% decrease in SV (p = 0.02), and SV response declined progressively with right ventricular dilation (7-ml decrease in SV per 100-ml increase in RVEDV; p < 0.001).CONCLUSIONS: Assessment of right ventricular function with CMR during exercise stratifies patients currently perceived as having a low risk of mortality into different degrees of right ventricular inotropic reserve. Reduced SV during exercise is a plausible factor to increased risk of decompensation, possibly warranting targeted therapy intensification to restore right ventricular functional reserve.

AB - BACKGROUND: Patients with pulmonary arterial hypertension (PAH) have a decreased ability to compensate for demands on increased cardiac output, such as during exercise. In this study we aimed to differentiate cardiac exercise responses in patients with PAH, stratified according to known measurements of disease severity.METHODS: Right and left ventricular end-diastolic volume and end-systolic volume, stroke volume (SV), and cardiac output were measured in 20 patients with PAH and a lower risk of mortality with 6-month intervals using cardiovascular magnetic resonance (CMR) imaging during rest and during ergometer exercise (totaling 44 scans). Exercise measurements were compared with resting cardiac conditions and clinical assessment using mixed model statistics.RESULTS: SV response during exercise was associated with disease severity. World Health Organization functional class (WHO FC) I and right ventricular end-diastolic volume (RVEDV) <221 ml were associated with increased SV during exercise (WHO FC I: 7% increase in SV; p < 0.001). In contrast, WHO FC II was associated with an 8% decrease in SV (p = 0.02), and SV response declined progressively with right ventricular dilation (7-ml decrease in SV per 100-ml increase in RVEDV; p < 0.001).CONCLUSIONS: Assessment of right ventricular function with CMR during exercise stratifies patients currently perceived as having a low risk of mortality into different degrees of right ventricular inotropic reserve. Reduced SV during exercise is a plausible factor to increased risk of decompensation, possibly warranting targeted therapy intensification to restore right ventricular functional reserve.

KW - cardiovascular magnetic resonance imaging

KW - exercise

KW - pulmonary arterial hypertension

KW - right ventricular function

KW - risk assessment

KW - stroke volume

U2 - 10.1016/j.healun.2019.01.1305

DO - 10.1016/j.healun.2019.01.1305

M3 - Journal article

VL - 38

SP - 627

EP - 635

JO - Journal of Heart and Lung Transplantation

JF - Journal of Heart and Lung Transplantation

SN - 1053-2498

IS - 6

ER -

ID: 57663776