title: Prognostic value of pulmonary vascular resistance estimated by cardiac magnetic resonance in patients with chronic heart failure.
abstract: OBJECTIVE
  Pulmonary arterial hypertension is known to be related to worse prognosis in patients with heart failure (HF). Quantification of pulmonary vascular resistance (PVR) still requires invasive right heart catheterization. Recent studies have shown an accurate method for non-invasive estimation of PVR by cardiac magnetic resonance (CMR). Our aim was to evaluate the prognostic value of PVR calculated by CMR in patients with congestive HF.
  
  
  RESULTS
  We calculated PVR by CMR in 132 patients [age 65.6 ± 13.1 years, left ventricular ejection fraction (LVEF) 35.1 ± 16.4%, ischaemic aetiology 40%] recently admitted for decompensated HF and derived to our cardiac imaging unit for diagnosis. Patients with cardiac events (readmission for HF or all-cause death) had higher values of PVR [6.77 ± 1.9 vs. 4.1 ± 1.6 Wood units (Wu), P < 0.001] during follow-up [mean 10.3 (1-31) months]. In multivariable Cox regression analysis, only a PVR ≥5.2 Wu [hazard ratio (HR) 4.27; 95% confidence interval (CI) 1.75-10.42; P < 0.001) and the presence of late gadolinium enhancement (LGE) on CMR (HR 2.24; 95% CI 1.03-4.86; P = 0.04) were independent predictors for adverse events at follow-up.
  
  
  CONCLUSIONS
  Non-invasive estimation of PVR by CMR might be useful for risk stratification of patients with chronic HF, irrespective of aetiology or LVEF.
authors.affiliation: Cardiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain Research Foundation, Hospital General Universitario, Valencia, Spain osfabregat@gmail.com.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Fabregat-Andrés
authors.affiliation: Cardiac Imaging Unit, ERESA, Valencia, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Estornell-Erill
authors.affiliation: Cardiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain Department of Medicine, Universitat de Valencia, Valencia, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Ridocci-Soriano
authors.affiliation: Cardiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: García-González
authors.affiliation: Cardiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
authors.forename: Bruno
authors.initials: B
authors.lastname: Bochard-Villanueva
authors.affiliation: Cardiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Cubillos-Arango
authors.affiliation: Cardiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
authors.forename: Rafael de la
authors.initials: Rde L
authors.lastname: Espriella-Juan
authors.affiliation: Cardiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fácila
authors.affiliation: Cardiology Department, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
authors.forename: Salvador
authors.initials: S
authors.lastname: Morell
authors.affiliation: Research Foundation, Hospital General Universitario, Valencia, Spain Department of Pharmacology, Universitat de Valencia, Valencia, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Cortijo
mesh_terms: D000368:Aged; D002908:Chronic Disease; D017023:Coronary Angiography / Q000379:methods; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D014655:Vascular Resistance; D016277:Ventricular Function, Left
keywords: Cardiac magnetic resonance; Heart failure; Non-invasive estimation; Prognosis; Pulmonary hypertension; Pulmonary vascular resistances