Right ventricular relative wall thickness as a predictor of outcomes and of right ventricular reverse remodeling for patients with pulmonary hypertension
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Mid-term right ventricular (RV) reverse remodeling after treatment in patients with pulmonary hypertension (PH) is associated with long-term outcome as well as baseline RV remodeling. However, baseline factors influencing mid-term RV reverse remodeling after treatment and its prognostic capability remain unclear. We studied 54 PH patients. Mid-term RV remodeling was assessed in terms of the RV area, which was traced planimetrically at the end-systole (RVESA). RV reverse remodeling was defined as a relative decrease in the RVESA of at least 15% at 10.2 ± 9.4 months after treatment. Long-term follow-up was 5 years. Adverse events occurred in ten patients (19%) and mid-term RV reverse remodeling after treatment was observed in 37 (69%). Patients with mid-term RV reverse remodeling had more favorable long-term outcomes than those without (log-rank: p = 0.01). Multivariate logistic regression analysis showed that RV relative wall thickness (RV-RWT), as calculated as RV free-wall thickness/RV basal linear dimension at end-diastole, was an independent predictor of mid-term RV reverse remodeling (OR 1.334; 95% CI, 1.039–1.713; p = 0.03). Moreover, patients with RV-RWT ≥0.21 showed better long-term outcomes than did those without (log-rank p = 0.03), while those with RV-RWT ≥0.21 and mid-term RV reverse remodeling had the best long-term outcomes. Patients with RV-RWT <0.21 and without mid-term RV reverse remodeling, on the other hand, had worse long-term outcomes than other sub-groups. In conclusions, RV-RWT could predict mid-term RV reverse remodeling after treatment in PH patients, and was associated with long-term outcomes. Our finding may have clinical implications for better management of PH patients.
KeywordsPulmonary hypertension Right ventricular function Right ventricular reverse remodeling Echocardiography
Compliance with ethical standards
Conflict of interest
Hiroyuki Sano declares that he has no conflict of interest. Hidekazu Tanaka declares that he has no conflict of interest. Yoshiki Motoji declares that he has no conflict of interest. Yuko Fukuda declares that he has no conflict of interest. Yasuhide Mochizuki declares that he has no conflict of interest. Yutaka Hatani declares that he has no conflict of interest. Hiroki Matsuzoe declares that she has no conflict of interest. Keiko Hatazawa declares that he has no conflict of interest. Hiroyuki Shimoura declares that he has no conflict of interest. Junichi Ooka declares that he has no conflict of interest. Keiko Ryo-Koriyama declares that he has no conflict of interest. Kazuhiro Nakayama declares that he has no conflict of interest. Kensuke Matsumoto declares that he has no conflict of interest. Noriaki Emoto declares that he has no conflict of interest. Ken-ichi Hirata declares that he has no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was obtained from the patient.
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