title: Bi-ventricular interplay in patients with systemic sclerosis-associated pulmonary arterial hypertension: Detection by cardiac magnetic resonance.
abstract: OBJECTIVE
  Pulmonary arterial hypertension (PAH) associated with systemic sclerosis (SSc) has a poor prognosis compared to PAH associated with other connective tissue diseases (CTD). The objective of this study was to examine the difference in hemodynamic state between SSc-PAH and other CTD-PAH by performing cardiac magnetic resonance (CMR) imaging.
  
  
  METHODS
  A single center retrospective analysis was conducted comprising 40 consecutive CTD patients who underwent right heart catheterization and CMR at the same period from January 2010 to October 2015.
  
  
  RESULTS
  Thirty-two patients had pre-capillary pulmonary hypertension. Of these, 15 had SSc and 17 had other CTD. CMR measurements, particularly the ratio of right to left end-diastolic volume (RVEDV/LVEDV), correlated well with mean pulmonary arterial pressure (mPAP). Conversely, RVEDV/LVEDV and mPAP correlated differently in SSc and non-SSc patients. In SSc patients, the ratio of RVEDV/LVEDV to mPAP was significantly higher compared to non-SSc patients. In the follow-up study, 2 SSc patients exhibited increased RVEDV/LVEDV in spite of decreased mPAP following treatment. Kaplan-Meier analysis revealed poor prognosis of patients with increased RVEDV/LVEDV following treatment.
  
  
  CONCLUSIONS
  Our data indicated that altered bi-ventricular interplay detected at CMR may represent SSc-related cardiac involvement and reflect poor prognosis of SSc-PAH.
authors.affiliation: a Division of Rheumatology, Endocrinology and Nephrology , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Noguchi
authors.affiliation: a Division of Rheumatology, Endocrinology and Nephrology , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Kato
authors.affiliation: a Division of Rheumatology, Endocrinology and Nephrology , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Michihito
authors.initials: M
authors.lastname: Kono
authors.affiliation: a Division of Rheumatology, Endocrinology and Nephrology , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Ohmura
authors.affiliation: b First Department of Medicine , and.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohira
authors.affiliation: b First Department of Medicine , and.
authors.forename: Ichizo
authors.initials: I
authors.lastname: Tsujino
authors.affiliation: c Department of Diagnostic and Interventional Radiology , Hokkaido University Hospital , Sapporo , Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Oyama-Manabe
authors.affiliation: a Division of Rheumatology, Endocrinology and Nephrology , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Oku
authors.affiliation: a Division of Rheumatology, Endocrinology and Nephrology , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Bohgaki
authors.affiliation: a Division of Rheumatology, Endocrinology and Nephrology , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Horita
authors.affiliation: a Division of Rheumatology, Endocrinology and Nephrology , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Yasuda
authors.affiliation: b First Department of Medicine , and.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nishimura
authors.affiliation: a Division of Rheumatology, Endocrinology and Nephrology , Hokkaido University Graduate School of Medicine , Sapporo , Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Atsumi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000150:complications / Q000000981:diagnostic imaging*
keywords: Cardiac magnetic resonance; Connective tissue diseases; Prognosis; Pulmonary arterial hypertension; Systemic sclerosis