학술논문

Ventricular global function index is associated with clinical outcomes in pediatric pulmonary hypertension
Document Type
article
Source
Journal of Cardiovascular Magnetic Resonance, Vol 25, Iss 1, Pp 1-9 (2023)
Subject
Pediatric pulmonary hypertension
Global function index
Cardiovascular magnetic resonance
Diseases of the circulatory (Cardiovascular) system
RC666-701
Language
English
ISSN
1532-429X
Abstract
Abstract Background Multiple right ventricular (RV) metrics have prognostic value in pulmonary hypertension (PH). A cardiac magnetic resonance imaging (CMR) derived global ventricular function index (GFI) provided improved prediction of composite adverse outcome (CAO) in adults with atherosclerosis. GFI has not yet been explored in a PH population. We explored the feasibility of GFI as a predictor of CAO in a pediatric PH population. Methods Two center retrospective chart review identified pediatric PH patients undergoing CMR from Jan 2005–June 2021. GFI, defined as the ratio of the stroke volume to the sum of mean ventricular cavity and myocardial volume, was calculated for each patient. CAO was defined as death, lung transplant, Potts shunt, or parenteral prostacyclin initiation after CMR. Cox proportional hazards regression was used to estimate associations and assess model performance between CMR parameters and CAO. Results The cohort comprised 89 patients (54% female, 84% World Health Organization (WHO) Group 1; 70% WHO-FC ≤ 2; and 27% on parenteral prostacyclin). Median age at CMR was 12 years (IQR 8.1–17). Twenty-one (24%) patients experienced CAO during median follow up of 1.5 years. CAO cohort had higher indexed RV volumes (end systolic—145 vs 99 mL/m2, p = 0.003; end diastolic—89 vs 46 mL/m2, p = 0.004) and mass (37 vs 24 gm/m2, p = 0.003), but lower ejection fraction (EF) (42 vs 51%, p