TY - JOUR
T1 - Bi-ventricular interplay in patients with systemic sclerosis-associated pulmonary arterial hypertension
T2 - Detection by cardiac magnetic resonance
AU - Noguchi, Atsushi
AU - Kato, Masaru
AU - Kono, Michihito
AU - Ohmura, Kazumasa
AU - Ohira, Hiroshi
AU - Tsujino, Ichizo
AU - Oyama-Manabe, Noriko
AU - Oku, Kenji
AU - Bohgaki, Toshiyuki
AU - Horita, Tetsuya
AU - Yasuda, Shinsuke
AU - Nishimura, Masaharu
AU - Atsumi, Tatsuya
N1 - Publisher Copyright:
© 2016 Japan College of Rheumatology.
PY - 2017/5/4
Y1 - 2017/5/4
N2 - Objectives: Pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc) has a poor prognosis compared to PAH associated with other connective tissue diseases (CTD). The objective of this study was to examine the difference in hemodynamic state between SSc-PAH and other CTD-PAH by performing cardiac magnetic resonance (CMR) imaging. Methods: A single center retrospective analysis was conducted comprising 40 consecutive CTD patients who underwent right heart catheterization and CMR at the same period from January 2010 to October 2015. Results: Thirty-two patients had pre-capillary pulmonary hypertension. Of these, 15 had SSc and 17 had other CTD. CMR measurements, particularly the ratio of right to left end-diastolic volume (RVEDV/LVEDV), correlated well with mean pulmonary arterial pressure (mPAP). Conversely, RVEDV/LVEDV and mPAP correlated differently in SSc and non-SSc patients. In SSc patients, the ratio of RVEDV/LVEDV to mPAP was significantly higher compared to non-SSc patients. In the follow-up study, 2 SSc patients exhibited increased RVEDV/LVEDV in spite of decreased mPAP following treatment. Kaplan–Meier analysis revealed poor prognosis of patients with increased RVEDV/LVEDV following treatment. Conclusions: Our data indicated that altered bi-ventricular interplay detected at CMR may represent SSc-related cardiac involvement and reflect poor prognosis of SSc-PAH.
AB - Objectives: Pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc) has a poor prognosis compared to PAH associated with other connective tissue diseases (CTD). The objective of this study was to examine the difference in hemodynamic state between SSc-PAH and other CTD-PAH by performing cardiac magnetic resonance (CMR) imaging. Methods: A single center retrospective analysis was conducted comprising 40 consecutive CTD patients who underwent right heart catheterization and CMR at the same period from January 2010 to October 2015. Results: Thirty-two patients had pre-capillary pulmonary hypertension. Of these, 15 had SSc and 17 had other CTD. CMR measurements, particularly the ratio of right to left end-diastolic volume (RVEDV/LVEDV), correlated well with mean pulmonary arterial pressure (mPAP). Conversely, RVEDV/LVEDV and mPAP correlated differently in SSc and non-SSc patients. In SSc patients, the ratio of RVEDV/LVEDV to mPAP was significantly higher compared to non-SSc patients. In the follow-up study, 2 SSc patients exhibited increased RVEDV/LVEDV in spite of decreased mPAP following treatment. Kaplan–Meier analysis revealed poor prognosis of patients with increased RVEDV/LVEDV following treatment. Conclusions: Our data indicated that altered bi-ventricular interplay detected at CMR may represent SSc-related cardiac involvement and reflect poor prognosis of SSc-PAH.
KW - Cardiac magnetic resonance
KW - Connective tissue diseases
KW - Prognosis
KW - Pulmonary arterial hypertension
KW - Systemic sclerosis
UR - http://www.scopus.com/inward/record.url?scp=84982288433&partnerID=8YFLogxK
U2 - 10.1080/14397595.2016.1218597
DO - 10.1080/14397595.2016.1218597
M3 - 学術論文
C2 - 27535805
AN - SCOPUS:84982288433
SN - 1439-7595
VL - 27
SP - 481
EP - 488
JO - Modern Rheumatology
JF - Modern Rheumatology
IS - 3
ER -