title: Changes in right ventricular function measured by cardiac magnetic resonance imaging in patients receiving pulmonary arterial hypertension-targeted therapy: the EURO-MR study.
abstract: Most measures that predict survival in pulmonary hypertension (PH) relate directly to, or correlate with, right ventricular (RV) function. Direct assessment of RV function using noninvasive techniques such as cardiac MRI may therefore be an appropriate way of determining response to therapy and monitoring disease progression in PH.
  
  
  
  In this pan-European study, 91 patients with PH (mean pulmonary arterial pressure 46±15 mm Hg) underwent clinical and cardiac MRI assessments at baseline and after 12 months of disease-targeted therapy (predominantly endothelin receptor antagonists [47.3%] or phosphodiesterase type-5 inhibitors [25.3%]). At month 12, functional class had improved in 21 patients, was unchanged in 63 patients, and had deteriorated in 7 patients. Significant improvements were achieved in RV and left ventricular ejection fraction (P<0.001 and P=0.0007, respectively), RV stroke volume index (P<0.0001), and left ventricular end-diastolic volume index (P=0.0015). Increases in 6-minute walk distance were significant (P<0.0001) and correlated with change in RV ejection fraction and left ventricular end-diastolic volume, although correlation coefficients were low (r=0.28, P=0.01 and r=0.26, P=0.02, respectively).
  
  
  
  On-treatment changes in cardiac MRI-derived variables from left and right sides of the heart reflected changes in functional class and survival in patients with PH. Direct measurement of RV function using cardiac MRI can fully assess potential benefits of treatment in PH.
authors.affiliation: Scottish Pulmonary Vascular Unit, Glasgow, United Kingdom.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Peacock
authors.forename: Stephen
authors.initials: S
authors.lastname: Crawley
authors.forename: Lindsey
authors.initials: L
authors.lastname: McLure
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Blyth
authors.forename: Carmine Dario
authors.initials: CD
authors.lastname: Vizza
authors.forename: Roberto
authors.initials: R
authors.lastname: Poscia
authors.forename: Marco
authors.initials: M
authors.lastname: Francone
authors.forename: Ilaria
authors.initials: I
authors.lastname: Iacucci
authors.forename: Horst
authors.initials: H
authors.lastname: Olschewski
authors.forename: Gabor
authors.initials: G
authors.lastname: Kovacs
authors.forename: Anton
authors.initials: A
authors.lastname: Vonk Noordegraaf
authors.forename: J Tim
authors.initials: JT
authors.lastname: Marcus
authors.forename: Marielle C
authors.initials: MC
authors.lastname: van de Veerdonk
authors.forename: Frank P T
authors.initials: FP
authors.lastname: Oosterveer
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D062186:Arterial Pressure / Q000187:drug effects; D018450:Disease Progression; D065128:Endothelin Receptor Antagonists; D005060:Europe; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000187:drug effects / Q000503:physiopathology; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects; D016278:Ventricular Function, Right / Q000187:drug effects*
chemical_list: D000959:Antihypertensive Agents; D065128:Endothelin Receptor Antagonists; D058986:Phosphodiesterase 5 Inhibitors
keywords: hypertension, pulmonary; magnetic resonance imaging; right ventricle