Open AccessPrognostic value of right ventricular native T1 mapping in pulmonary arterial hypertension
Author(s) -
Ryotaro Asano,
Takeshi Ogo,
Yoshiaki Morita,
Akiyuki Kotoku,
Tatsuo Aoki,
Kyoko Hirakawa,
Sayuri Nakayama,
Jin Ueda,
Akiko Tsuji,
Mark T. Waddingham,
Yoshiji Ohta,
Tsuyoshi Fukuda,
Keiko OhtaOgo,
Hatsue IshibashiUeda,
Teruo Noguchi,
Satoshi Yasuda
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0260456
Subject(s) - cardiology , medicine , pulmonary hypertension , pulmonary artery , ejection fraction , hazard ratio , cardiac magnetic resonance imaging , ventricular pressure , magnetic resonance imaging , brain natriuretic peptide , blood pressure , heart failure , confidence interval , radiology
Background Right ventricular function is an important prognostic marker for pulmonary arterial hypertension. Native T1 mapping using cardiovascular magnetic resonance imaging can characterize the myocardium, but accumulating evidence indicates that T1 values of the septum or ventricular insertion points do not have predictive potential in pulmonary arterial hypertension. We aimed to elucidate whether native T1 values of the right ventricular free wall (RVT1) can predict poor outcomes in patients with pulmonary arterial hypertension. Methods This retrospective study included 30 patients with pulmonary arterial hypertension (median age, 45 years; mean pulmonary artery pressure, 41±13 mmHg) and 16 healthy controls (median age, 43 years) who underwent native T1 mapping. RVT1 was obtained from the inferior right ventricular free wall during end systole. Results Patients with pulmonary arterial hypertension had significantly higher native RVT1 than did controls (1384±74 vs. 1217±57 ms, p<0.001). Compared with T1 values of the septum or ventricular insertion points, RVT1 correlated better with the effective right ventricular elastance index (R = −0.53, p = 0.003), ventricular-arterial uncoupling (R = 0.46, p = 0.013), and serum brain natriuretic peptide levels (R = 0.65, p<0.001). Moreover, the baseline RVT1 was an accurate predictor of the reduced right ventricular ejection fraction at the 12-month follow-up (delta -3%). RVT1 was independently associated with composite events of death or hospitalization from any cause (hazard ratio = 1.02, p = 0.002). Conclusions RVT1 was predictive of right ventricular performance and outcomes in patients with pulmonary arterial hypertension. Thus, native T1 mapping in the right ventricular free wall may be an effective prognostic method for pulmonary arterial hypertension.