Association of right ventricular pressure and volume overload with non-ischemic septal fibrosis on cardiac magnetic resonance Journal Article
| Authors: | Kim, J.; Medicherla, C. B.; Ma, C. L.; Feher, A.; Kukar, N.; Geevarghese, A.; Goyal, P.; Horn, E.; Devereux, R. B.; Weinsaft, J. W. |
| Article Title: | Association of right ventricular pressure and volume overload with non-ischemic septal fibrosis on cardiac magnetic resonance |
| Abstract: | Background Non-ischemic fibrosis (NIF) on cardiac magnetic resonance (CMR) has been linked to poor prognosis, but its association with adverse right ventricular (RV) remodeling is unknown. This study examined a broad cohort of patients with RV dysfunction, so as to identify relationships between NIF and RV remodeling indices, including RV pressure load, volume and wall stress. Methods and Results The population comprised patients with RV dysfunction (EF<50%) undergoing CMR and transthoracic echo within a 14 day (5±3) interval. Cardiac structure, function, and NIF were assessed on CMR. Pulmonary artery systolic pressure (PASP) was measured on echo. 118 patients with RV dysfunction were studied, among whom 47% had NIF. Patients with NIF had lower RVEF (34±10 vs. 39±9%; p = 0.01) but similar LVEF (40±21 vs. 39±18%; p = 0.7) and LV volumes (p = NS). RV wall stress was higher with NIF (17±7 vs. 12±6 kPa; p<0.001) corresponding to increased RV end-systolic volume (143±79 vs. 110±36 ml; p = 0.006), myocardial mass (60±21 vs. 53±17 gm; p = 0.04), and PASP (52±18 vs. 41±18 mmHg; p = 0.001). NIF was associated with increased wall stress among subgroups with isolated RV (p = 0.005) and both RV and LV dysfunction (p = 0.003). In multivariable analysis, NIF was independently associated with RV volume (OR = 1.17 per 10 ml, [CI 1.04 1.32]; p = 0.01) and PASP (OR = 1.43 per 10 mmHg, [1.141.81]; p = 0.002) but not RV mass (OR = 0.91 per 10 gm, [0.69 1.20]; p = 0.5) [model 2 = 21; p<0.001]. NIF prevalence was higher in relation to PA pressure and RV dilation and was > 6-fold more common in the highest, vs. the lowest, common tertile of PASP and RV size (p<0.001). © 2016 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
| Journal Title: | PLoS ONE |
| Volume: | 11 |
| Issue: | 1 |
| ISSN: | 1932-6203 |
| Publisher: | Public Library of Science |
| Date Published: | 2016-01-22 |
| Start Page: | e0147349 |
| Language: | English |
| DOI: | 10.1371/journal.pone.0147349 |
| PROVIDER: | scopus |
| PMCID: | PMC4723145 |
| PUBMED: | 26799498 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 March 2016 -- Source: Scopus |
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