Kaplan Meier plot showing the prognostic significance of sex in age matched patients with IPAH.

<p>Kaplan Meier plot showing the prognostic significance of sex in age matched patients with IPAH.</p

Corrected RVEDV, RVEF and RV mass indices in age matched males and female patients with IPAH, correction using Kawut reference data[17].

<p>MRI data are expressed as percentage predicted.</p><p>BSA = body surface area, RV EDV = right ventricular end-diastolic volume, RV EF = right ventricular ejection fraction.</p><p>*corrected for age, sex and BSA (% predicted) Kawut [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0127415#pone.0127415.ref017" target="_blank">17</a>].</p><p>Corrected RVEDV, RVEF and RV mass indices in age matched males and female patients with IPAH, correction using Kawut reference data[<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0127415#pone.0127415.ref017" target="_blank">17</a>].</p

Bar charts showing reduced right ventricular ejection fraction (RVEF) and right ventricular stroke volume (RVESV) in male patients with IPAH.

<p>No significant (NS) difference between right ventricular end diastolic mass or pulmonary vascular resistance (PVR) between males and females. RVEF, RVSV and RVEDM corrected for age, sex (presented as % predicted)</p

Comparison of cardiac volume mass and function between women above 50 (N = 30) and below or equal to the age of 50 (N = 10) with IPAH.

<p>MRI data are expressed as percentage predicted.</p><p>RV EDV = right ventricular end-diastolic volume, RV ESV = right ventricular end-systolic volume index, RV EF = right ventricular ejection fraction, VMI = ventricular mass index, LV EDV = left ventricular end-diastolic volume index, LV ESV = left ventricular end-systolic volume index, LVEF = left ventricular ejection fraction, LV SV = left ventricular stroke volume index.</p><p>*Corrected for age, sex and BSA (%).</p><p>Comparison of cardiac volume mass and function between women above 50 (N = 30) and below or equal to the age of 50 (N = 10) with IPAH.</p

Demographic, invasive haemodynamic and corrected MR indices in age matched males and female patients with IPAH.

<p>MRI data are expressed as percentage predicted</p><p>WHO = world health organisation, mRAP = mean right atrial pressure, mPAP = mean pulmonary artery pressure, PCWP = pulmonary capillary wedge pressure, PVR = pulmonary vascular resistance, CO = cardiac output, Svo2 = mixed venous oxygen saturations, RV EDV = right ventricular end-diastolic volume, RV ESV = right ventricular end-systolic volume index, RV EF = right ventricular ejection fraction, VMI = ventricular mass index, LV EDV = left ventricular end-diastolic volume index, LV ESV = left ventricular end-systolic volume index, LVEF = left ventricular ejection fraction, LV SV = left ventricular stroke volume index.</p><p>* corrected for age, sex and BSA (% predicted) Maceria [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0127415#pone.0127415.ref015" target="_blank">15</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0127415#pone.0127415.ref016" target="_blank">16</a>].</p><p>Demographic, invasive haemodynamic and corrected MR indices in age matched males and female patients with IPAH.</p

Diagnostic accuracy of cardiovascular magnetic resonance imaging of right ventricular morphology and function in the assessment of suspected pulmonary hypertension results from the ASPIRE registry

<p>Abstract</p> <p>Background</p> <p>Cardiovascular Magnetic Resonance (CMR) imaging is accurate and reproducible for the assessment of right ventricular (RV) morphology and function. However, the diagnostic accuracy of CMR derived RV measurements for the detection of pulmonary hypertension (PH) in the assessment of patients with suspected PH in the clinic setting is not well described.</p> <p>Methods</p> <p>We retrospectively studied 233 consecutive treatment naïve patients with suspected PH including 39 patients with no PH who underwent CMR and right heart catheterisation (RHC) within 48hours. The diagnostic accuracy of multiple CMR measurements for the detection of mPAP ≥ 25 mmHg was assessed using Fisher’s exact test and receiver operating characteristic (ROC) analysis.</p> <p>Results</p> <p>Ventricular mass index (VMI) was the CMR measurement with the strongest correlation with mPAP (r = 0.78) and the highest diagnostic accuracy for the detection of PH (area under the ROC curve of 0.91) compared to an ROC of 0.88 for echocardiography calculated mPAP. Late gadolinium enhancement, VMI ≥ 0.4, retrograde flow ≥ 0.3 L/min/m² and PA relative area change ≤ 15% predicted the presence of PH with a high degree of diagnostic certainty with a positive predictive value of 98%, 97%, 95% and 94% respectively. No single CMR parameter could confidently exclude the presence of PH.</p> <p>Conclusion</p> <p>CMR is a useful alternative to echocardiography in the evaluation of suspected PH. This study supports a role for the routine measurement of ventricular mass index, late gadolinium enhancement and the use of phase contrast imaging in addition to right heart functional indices in patients undergoing diagnostic CMR evaluation for suspected pulmonary hypertension.</p