Non-Invasive Risk Prediction Based on Right Ventricular Function in Patients with Pulmonary Arterial Hypertension

Background: Right ventricular dysfunction is a major determinant of outcome in pulmonary arterial hypertension (PAH). We aimed to identify echocardiographic right heart parameters associated with adverse outcome and to develop a non-invasive, echocardiography-based risk score for PAH patients. Metho...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Vazhma Qaderi, Jessica Weimann, Lars Harbaum, Benedikt N. Schrage, Dorit Knappe, Jan K. Hennigs, Christoph Sinning, Renate B. Schnabel, Stefan Blankenberg, Paulus Kirchhof, Hans Klose, Christina Magnussen
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	pulmonary arterial hypertension risk score echocardiography tricuspid annular plane systolic excursion fractional area change Medicine R
Acceso en línea:	https://doaj.org/article/f9df722ce816471ba6e54908fe933ae8
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:f9df722ce816471ba6e54908fe933ae8
record_format	dspace
spelling	oai:doaj.org-article:f9df722ce816471ba6e54908fe933ae82021-11-11T17:45:18ZNon-Invasive Risk Prediction Based on Right Ventricular Function in Patients with Pulmonary Arterial Hypertension10.3390/jcm102151302077-0383https://doaj.org/article/f9df722ce816471ba6e54908fe933ae82021-10-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5130https://doaj.org/toc/2077-0383Background: Right ventricular dysfunction is a major determinant of outcome in pulmonary arterial hypertension (PAH). We aimed to identify echocardiographic right heart parameters associated with adverse outcome and to develop a non-invasive, echocardiography-based risk score for PAH patients. Methods and Results: In 254 PAH patients we analyzed functional status, laboratory results, and echocardiographic parameters. We included these parameters to estimate all-cause death or lung transplantation using Cox regression models. The analyses included a conventional model using guideline-recommended variables and an extended echocardiographic model. Based on the final model a 12-point risk score was derived, indicating the association with the primary outcome within five years. During a median follow-up time of 4.2 years 74 patients died or underwent lung transplantation. The conventional model resulted in a C-Index of 0.539, whereas the extended echocardiographic model improved the discrimination (C-index 0.639, <i>p</i>-value 0.017). Ultimately, the newly developed risk score included WHO functional class, 6-min walking distance, N-terminal brain natriuretic peptide concentrations, pericardial effusion, right atrial area, tricuspid annular plane systolic excursion, and fractional area change. Conclusion: Integrating right heart function assessed by echocardiography improves prediction of death or lung transplantation in PAH patients. Independent validation of this finding is warranted.Vazhma QaderiJessica WeimannLars HarbaumBenedikt N. SchrageDorit KnappeJan K. HennigsChristoph SinningRenate B. SchnabelStefan BlankenbergPaulus KirchhofHans KloseChristina MagnussenMDPI AGarticlepulmonary arterial hypertensionrisk scoreechocardiographytricuspid annular plane systolic excursionfractional area changeMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5130, p 5130 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pulmonary arterial hypertension risk score echocardiography tricuspid annular plane systolic excursion fractional area change Medicine R
spellingShingle	pulmonary arterial hypertension risk score echocardiography tricuspid annular plane systolic excursion fractional area change Medicine R Vazhma Qaderi Jessica Weimann Lars Harbaum Benedikt N. Schrage Dorit Knappe Jan K. Hennigs Christoph Sinning Renate B. Schnabel Stefan Blankenberg Paulus Kirchhof Hans Klose Christina Magnussen Non-Invasive Risk Prediction Based on Right Ventricular Function in Patients with Pulmonary Arterial Hypertension
description	Background: Right ventricular dysfunction is a major determinant of outcome in pulmonary arterial hypertension (PAH). We aimed to identify echocardiographic right heart parameters associated with adverse outcome and to develop a non-invasive, echocardiography-based risk score for PAH patients. Methods and Results: In 254 PAH patients we analyzed functional status, laboratory results, and echocardiographic parameters. We included these parameters to estimate all-cause death or lung transplantation using Cox regression models. The analyses included a conventional model using guideline-recommended variables and an extended echocardiographic model. Based on the final model a 12-point risk score was derived, indicating the association with the primary outcome within five years. During a median follow-up time of 4.2 years 74 patients died or underwent lung transplantation. The conventional model resulted in a C-Index of 0.539, whereas the extended echocardiographic model improved the discrimination (C-index 0.639, <i>p</i>-value 0.017). Ultimately, the newly developed risk score included WHO functional class, 6-min walking distance, N-terminal brain natriuretic peptide concentrations, pericardial effusion, right atrial area, tricuspid annular plane systolic excursion, and fractional area change. Conclusion: Integrating right heart function assessed by echocardiography improves prediction of death or lung transplantation in PAH patients. Independent validation of this finding is warranted.
format	article
author	Vazhma Qaderi Jessica Weimann Lars Harbaum Benedikt N. Schrage Dorit Knappe Jan K. Hennigs Christoph Sinning Renate B. Schnabel Stefan Blankenberg Paulus Kirchhof Hans Klose Christina Magnussen
author_facet	Vazhma Qaderi Jessica Weimann Lars Harbaum Benedikt N. Schrage Dorit Knappe Jan K. Hennigs Christoph Sinning Renate B. Schnabel Stefan Blankenberg Paulus Kirchhof Hans Klose Christina Magnussen
author_sort	Vazhma Qaderi
title	Non-Invasive Risk Prediction Based on Right Ventricular Function in Patients with Pulmonary Arterial Hypertension
title_short	Non-Invasive Risk Prediction Based on Right Ventricular Function in Patients with Pulmonary Arterial Hypertension
title_full	Non-Invasive Risk Prediction Based on Right Ventricular Function in Patients with Pulmonary Arterial Hypertension
title_fullStr	Non-Invasive Risk Prediction Based on Right Ventricular Function in Patients with Pulmonary Arterial Hypertension
title_full_unstemmed	Non-Invasive Risk Prediction Based on Right Ventricular Function in Patients with Pulmonary Arterial Hypertension
title_sort	non-invasive risk prediction based on right ventricular function in patients with pulmonary arterial hypertension
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/f9df722ce816471ba6e54908fe933ae8
work_keys_str_mv	AT vazhmaqaderi noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT jessicaweimann noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT larsharbaum noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT benediktnschrage noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT doritknappe noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT jankhennigs noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT christophsinning noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT renatebschnabel noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT stefanblankenberg noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT pauluskirchhof noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT hansklose noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension AT christinamagnussen noninvasiveriskpredictionbasedonrightventricularfunctioninpatientswithpulmonaryarterialhypertension
_version_	1718432037867618304

Non-Invasive Risk Prediction Based on Right Ventricular Function in Patients with Pulmonary Arterial Hypertension

Ejemplares similares