Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Schmid, J; Kamml, C; Zweiker, D; Hatz, D; Schmidt, A; Reiter, U; Toth, GG; Fuchsjäger, M; Zirlik, A; Binder, JS; Rainer, PP.
Cardiac Magnetic Resonance Imaging Right Ventricular Longitudinal Strain Predicts Mortality in Patients Undergoing TAVI.
Front Cardiovasc Med. 2021; 8:644500
Doi: 10.3389/fcvm.2021.644500
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- Führende Autor*innen der Med Uni Graz
- Rainer Peter
- Schmid Johannes
- Co-Autor*innen der Med Uni Graz
- Binder Josepha Stephanie
- Fuchsjäger Michael
- Hatz Dominik
- Reiter Ursula
- Schmidt Albrecht
- Toth-Gayor Gabor
- Zirlik Andreas
- Zweiker David
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- Abstract:
- Background: Right ventricular (RV) function predicts survival in numerous cardiac conditions, including left heart disease. The reference standard for non-invasive assessment of RV function is cardiac magnetic resonance imaging (CMR). The aim of this study was to investigate the association between pre-procedural CMR-derived RV functional parameters and mortality in patients undergoing transcatheter aortic valve implantation (TAVI). Methods: Patients scheduled for TAVI were recruited to undergo pre-procedural CMR. Volumetric function and global longitudinal and circumferential strain (GLS and GCS) of the RV and left ventricle (LV) were measured. The association with the primary endpoint (1-year all-cause mortality) was analyzed with Cox regression. Results: Of 133 patients undergoing CMR, 113 patients were included in the analysis. Mean age was 81.8 ± 5.8 years, and 65% were female. Median follow-up was 3.9 [IQR 2.3-4.7] years. All-cause and cardiovascular mortality was 14 and 12% at 1 year, and 28 and 20% at 3 years, respectively. One-year all-cause mortality was significantly predicted by RV GLS [HR = 1.109 (95% CI: 1.023-1.203); p = 0.012], RV ejection fraction [HR = 0.956 (95% CI: 0.929-0.985); p = 0.003], RV end-diastolic volume index [HR = 1.009 (95% CI: 1.001-1.018); p = 0.025], and RV end-systolic volume index [HR = 1.010 (95% CI: 1.003-1.017); p = 0.005]. In receiver operating characteristic (ROC) analysis for 1-year all-cause mortality, the area under the curve was 0.705 (RV GLS) and 0.673 (RV EF). Associations decreased in strength at longer follow-up. None of the LV parameters was associated with mortality. Conclusions: RV function predicts intermediate-term mortality in TAVI patients while LV parameters were not associated with outcomes. Inclusion of easily obtainable RV GLS may improve future risk scores.
- Find related publications in this database (Keywords)
- transcatheter aortic valve implantation
- aortic valve stenosis
- magnetic resonance imaging
- MRI
- right ventricular function
- strain
- survival analysis
- mortality