title: Prognostic value of cardiac magnetic resonance imaging for idiopathic pulmonary arterial hypertension before initiating intravenous prostacyclin therapy.
abstract: BACKGROUND
  Because few have reported the prognostic significance of cardiac magnetic resonance imaging (CMR) for idiopathic pulmonary arterial hypertension (IPAH), in this study we evaluated the value of CMR measurements as a prognostic predictor of IPAH before starting intravenous prostacyclin therapy.
  
  
  RESULTS
  A total of 121 consecutive CMR studies for evaluating right ventricular (RV) function were reviewed. Forty-one patients were diagnosed with IPAH and served as the study group. Factors, such as age, sex, New York Heart Association functional class (NYHAFC), 6-min walk test, plasma brain natriuretic peptide level, serum uric acid level and CMR measurements were analyzed as predictors of first hospitalization and death. The mean follow-up period was 1,350±769 days. Nine patients were hospitalized because of heart failure, and 4 patients died from cardiopulmonary causes. The univariate analyses suggested that the left ventricular (LV) mass index, the left and right ventricular end-diastolic volume indices (LVEDVI, RVEDVI), the LV and RV end-systolic volume indices (LVESVI, RVESVI) and NYHAFC predicted the risk for hospitalization and that RVEDVI, RVESVI and NYHAFC predicted mortality. The multivariate analyses suggested that RVEDVI and NYHAFC are independent predictors of both hospitalization and mortality. The effects of RVEDVI and NYHAFC on hospitalization were not substantially affected by the concomitant medication.
  
  
  CONCLUSIONS
  In IPAH patients, the RVEDVI predicts both hospitalization for right heart failure and mortality before initiating intravenous prostacyclin therapy.
authors.affiliation: Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Yamada
authors.forename: Shigeo
authors.initials: S
authors.lastname: Okuda
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kataoka
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tanimoto
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tamura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Abe
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
authors.forename: Toru
authors.initials: T
authors.lastname: Satoh
authors.forename: Sachio
authors.initials: S
authors.lastname: Kuribayashi
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D011464:Epoprostenol / Q000008:administration & dosage*; D005080:Exercise Test; D017079:Exercise Tolerance; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014527:Uric Acid / Q000097:blood; D014665:Vasodilator Agents / Q000008:administration & dosage*; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain; D014527:Uric Acid; D011464:Epoprostenol