title: Prognostic value of right ventricular ejection fraction in pulmonary arterial hypertension.
abstract: Right ventricle ejection fraction (RVEF) evaluated with magnetic resonance imaging is a strong determinant of patient outcomes in pulmonary arterial hypertension. We evaluated the prognostic value of RVEF assessed with conventional planar equilibrium radionuclide angiography at baseline and change 3-6 months after initiating pulmonary arterial hypertension-specific therapy. In a prospective cohort of newly diagnosed patients with idiopathic, heritable or anorexigen-associated pulmonary arterial hypertension, RVEF was measured at baseline (n=100) and 3-6 months after initiation of therapy (n=78). After a median follow-up of 4.1 years, 41 deaths occurred, including 35 from cardiovascular causes. Patients with a (median) baseline RVEF >25% had better survival than those with a RVEF <25% using Kaplan-Meier analysis (p=0.010). RVEF at baseline was an independent predictor of all-cause and cardiovascular mortality in adjusted Cox regression model (p=0.002 and p=0.007, respectively; HR 0.93 for both). Patients with stable or increased RVEF at 3-6 months had a trend for improved all-cause survival (HR 2.43, p=0.086) and had less cardiovascular mortality (HR 3.25, p=0.034) than those in whom RVEF decreased despite therapy. RVEF assessed with conventional planar equilibrium radionuclide angiography at baseline and change in RVEF 3-6 months after therapy initiation independently predict outcomes in patients with pulmonary arterial hypertension.
authors.affiliation: Dept of Cardiology, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Courand
authors.affiliation: Dept of Nuclear Medicine, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Pina Jomir
authors.affiliation: Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France.
authors.forename: Chahéra
authors.initials: C
authors.lastname: Khouatra
authors.affiliation: Dept of Nuclear Medicine, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Scheiber
authors.affiliation: Dept of Respiratory Physiology, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France.
authors.forename: Ségolène
authors.initials: S
authors.lastname: Turquier
authors.affiliation: Dept of Respiratory Physiology, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France.
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Glérant
authors.affiliation: Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Mastroianni
authors.affiliation: Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Gentil
authors.affiliation: Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Blanchet-Legens
authors.affiliation: Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France. Claude Bernard University Lyon 1, INRA, UMR754 INRA-Vetagrosup EPHE IFR 128, Lyon, France.
authors.forename: Alfred
authors.initials: A
authors.lastname: Dib
authors.affiliation: Dept of Echocardiography, Hospices Civils de Lyon, Louis Pradel Hospital, Lyon, France.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Derumeaux
authors.affiliation: Univ. Paris-Sud, Le Kremlin-Bicêtre, France. AP-HP, Service de Pneumologie, DHU Thorax Innovation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. INSERM U999, LabEx LERMIT, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.
authors.forename: Marc
authors.identifier: http://orcid.org/0000-0003-0703-2892
authors.initials: M
authors.lastname: Humbert
authors.affiliation: Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France. Claude Bernard University Lyon 1, INRA, UMR754 INRA-Vetagrosup EPHE IFR 128, Lyon, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Mornex
authors.affiliation: Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France. Claude Bernard University Lyon 1, INRA, UMR754 INRA-Vetagrosup EPHE IFR 128, Lyon, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Cordier
authors.affiliation: Dept of Respiratory Diseases, Hospices Civils de Lyon, Louis Pradel Hospital, Service de pneumologie - National Reference Centre for Rare Pulmonary Diseases, Regional Competence Center for Severe Pulmonary Arterial Hypertension, Lyon, France. Claude Bernard University Lyon 1, INRA, UMR754 INRA-Vetagrosup EPHE IFR 128, Lyon, France. vincent.cottin@chu-lyon.fr.
authors.forename: Vincent
authors.initials: V
authors.lastname: Cottin
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000503:physiopathology*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology*; D012042:Registries; D013318:Stroke Volume; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology