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Right ventricular end-systolic remodelling index predicts outcomes in pulmonary arterial hypertension

12 Jul 2017
Donors' organs are distributed based on clinical criteria, such as waiting times, and suitability between donors and recipients.

The right ventricular end-systolic remodelling index (RVESRI) is a simple and good prognostic marker of outcomes in patients with pulmonary arterial hypertension, a new study shows.

Univariate analysis revealed that New York Heart Association class (NYHA; hazard ratio [HR], 3.36; 95 percent CI, 2.10 to 5.38; p<0.001), serum levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP; HR, 1.95; 1.57 to 2.42; p<0.001), right ventricular free wall longitudinal strain (RVLS; HR, 0.63; 0.51 to 0.82; p<0.001) and RVESRI (HR, 2.05; 1.66 to 2.53; p<0.001) were all significantly associated with death, transplant or admission.

After multivariate analysis, only NYHA class (HR, 1.96; 1.14 to 3.37; p=0.01), NT-proBNP levels (HR, 1.32; 1.01 to 1.73; p=0.04) and RVESRI (HR, 1.58; 1.22 to 2.04; p=0.001) remained significant predictors of the primary endpoint of death, lung transplant or admission for heart failure.

A comparison of other indices of RV end-systolic size or transverse-to-longitudinal ratio showed that RVESRI (χ2, 62; p<0.0001) was more accurately associated with the outcome than RV end-systolic area (RVESA)/height (χ2, 52; p<0.0001), RVESA/body surface area (χ2, 48; p<0.0001) and other indices.

The final model for the primary endpoint included NYHA class, RVESRI and NT-proBNP levels (χ2, 62.2; p<0.0001). The final model for the secondary endpoint of death or lung transplant included RVESRI and NT-proBNP levels (χ2, 42.40; p<0.0001).

The study included 228 pulmonary arterial hypertension patients (mean age 49±14 years; 78 percent female). RVESRI was calculated by dividing the lateral length by the septal height, both measured from echocardiographs.

Over a mean follow-up of 3.9±2.4 years, 43 deaths, 15 transplants and 30 admissions were reported, yielding a total of 88 events for the primary endpoint and 58 for the secondary endpoint.

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Most Read Articles
13 Jun 2017
Both haemorrhagic and ischaemic stroke patients benefit similarly from a conventional therapy combined with robotic-assisted gait training (RAGT) intervention regimen, a new study shows.
30 Jun 2016
Perindopril can protect patients with paroxysmal atrial fibrillation (AF) from recurrence after radiofrequency catheter ablation, as stated in a study.
6 days ago
Enriching salt with both potassium and magnesium in the long term may provide additional benefits for stroke patient recovery from neurologic deficits, suggests a recent study involving Taiwanese patients.