title: Left ventricular mass is preserved in patients with idiopathic pulmonary arterial hypertension and Eisenmenger's syndrome.
abstract: BACKGROUND
  Left ventricular (LV) atrophic remodelling was described for chronic thromboembolic pulmonary hypertension (PH) but not in other forms of PH. We aimed to assess LV morphometric changes in idiopathic pulmonary arterial hypertension (IPAH) and Eisenmenger's syndrome(ES).
  
  
  METHODS
  Fifteen patients with IPAH, 15 patients with ES and 15 healthy volunteers were included. Magnetic resonance was used to measure masses of LV, interventricular septum (IVS), LV free wall (LVFW), and LV end diastolic volume (LVEDV) indexed for body surface area.
  
  
  RESULTS
  Between patients with IPAH, ES and controls no differences in LVmassindex (54.4[45.2-63.3] vs 58.7[41.5-106.1] vs 52.8[46.5-59.3], p=0.50), IVSmassindex (21.6[18.2-21.9)] vs 27.4[18.0-32.9] vs 20.7[18.2-23.2], p=0.18), and LVFWmassindex ([32.4[27.1-40.0] vs 36.7[30.9-62.1] vs 32.5[26.9-36.1], p=0.29) were found. LVEDVindex was lower in IPAH patients than in controls and in ES patients (54.9[46.9-58.5] vs 75.2[62.4-88.9] vs 73.5[62.1-77.5], p<0.001). In IPAH LVEDV but not LV mass correlated with pulmonary vascular resistance (r=-0.56, p=0.03) and cardiac output (r=0.59, p=0.02).
  
  
  CONCLUSIONS
  LV mass is not reduced in patients with IPAH and with ES and is not affected by haemodynamic severity of PH. LVEDV is reduced in IPAH patients in proportion to reduced pulmonary flow but preserved in patients with ES, where reduced pulmonary flow to LV is compensated by right-to left shunt.
authors.affiliation: Department of Cardiac and Vascular Diseases of the John Paul II Hospital in Krakow and the Jagiellonian University Medical School in Krakow, Poland. Electronic address: gkopec@szpitaljp2.krakow.pl.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Kopeć
authors.affiliation: Department of Internal Medicine III (Cardiology and Emergency Medicine), Landesklinikum St. Poelten, St. Poelten, Austria.
authors.forename: Deddo
authors.initials: D
authors.lastname: Moertl
authors.affiliation: Center for Diagnosis, Prevention and Telemedicine at John Paul II Hospital in Krakow, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Miszalski-Jamka
authors.affiliation: Department of Cardiac and Vascular Diseases of the John Paul II Hospital in Krakow and the Jagiellonian University Medical School in Krakow, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Waligóra
authors.affiliation: Department of Cardiac and Vascular Diseases of the John Paul II Hospital in Krakow and the Jagiellonian University Medical School in Krakow, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Tyrka
authors.affiliation: Department of Cardiac and Vascular Diseases of the John Paul II Hospital in Krakow and the Jagiellonian University Medical School in Krakow, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Sarnecka
authors.affiliation: Department of Cardiac and Vascular Diseases of the John Paul II Hospital in Krakow and the Jagiellonian University Medical School in Krakow, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Podolec
mesh_terms: D000328:Adult; D004541:Eisenmenger Complex / Q000000981:diagnostic imaging / Q000503:physiopathology; D065627:Familial Primary Pulmonary Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011859:Radiography; D020257:Ventricular Remodeling
keywords: Cardiovascular magnetic resonance; Left ventricular hypotrophy; Left ventricular volume