Prognostic value of pulmonary blood volume by first-pass contrast-enhanced CMR in heart failure outpatients: the PROVE-HF study
| Autor: | Fabrizio Ricci, A Barison, Giancarlo Todiere, Gd Aquaro, S Galllina, Antonio Raffaele Cotroneo, Cesare Mantini, R. De Caterina, Michele Emdin |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Haemodynamic congestion Pulmonary Circulation Cardiac magnetic resonance Contrast Media Hemodynamics Perfusion scanning Blood volume Kaplan-Meier Estimate 030204 cardiovascular system & hematology Severity of Illness Index 030218 nuclear medicine & medical imaging Diastolic dysfunction Heart failure Pulmonary blood volume Radiology Nuclear Medicine and Imaging Cardiology and Cardiovascular Medicine 0302 clinical medicine Reference Values Nuclear Medicine and Imaging Outpatients Medicine Prospective Studies Prospective cohort study Blood Volume Hazard ratio General Medicine Stroke volume Middle Aged Prognosis Defibrillators Implantable Survival Rate Disease Progression Cardiology Female medicine.symptom Radiology medicine.medical_specialty Magnetic Resonance Imaging Cine Risk Assessment Asymptomatic Statistics Nonparametric 03 medical and health sciences Internal medicine Humans Radiology Nuclear Medicine and imaging Aged Proportional Hazards Models Heart Failure business.industry Stroke Volume medicine.disease Case-Control Studies business |
| Popis: | Aims Pulmonary blood volume (PBV) is a novel clinical application of cardiovascular magnetic resonance (CMR) imaging for the quantitative grading of haemodynamic congestion. In this study, we aimed to assess the prognostic value of PBV in a cohort of outpatients with chronic heart failure (HF). Methods and results One hundred and twelve consecutive patients (91 men, 67 ± 12 years) and 53 age- and sex-matched healthy controls underwent echocardiography and contrast-enhanced CMR. PBV was calculated as the product of stroke volume and the number of cardiac cycles for an intravenous bolus of gadolinium contrast to pass through the pulmonary circulation determined by first-pass perfusion imaging. Compared with healthy controls, HF outpatients showed significantly higher PBV index (PBVI, 308 ± 92 vs. 373 ± 175, mL/m2, P = 0.012) and pulmonary transit time (6.8 ± 1.8 vs. 9.5 ± 4 s, P ≤0.001). During a median follow-up of 26 ± 17 months, 27 patients (24%) reached the composite end point of cardiovascular death, HF hospitalization, or sustained ventricular arrhythmias/appropriate implantable cardioverter-defibrillator intervention. Using a cut-off point of PBVI >492 mL/m2, corresponding to two standard deviations above the mean of healthy controls, event-free survival was significantly lower in patients with higher PBVI (P |
| Databáze: | OpenAIRE |
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