Pulmonary vascular disease & thromboembolism
Classification and Predictors of Right Ventricular Functional Recovery in Pulmonary Arterial Hypertension
Authors' conclusion
RVFnRec defined by RV end-diastolic volume therapeutic decrease of -15 mL predicts exercise capacity, freedom from clinical worsening, and nears normalization. A therapeutic improvement of compliance is superior to other measures of afterload in predicting RVFnRec. RVFnRec is also associated with increased RV output reserve at exercise.
Study context
- Population
- Incident patients with pulmonary arterial hypertension, assessed at diagnosis and after treatment (≈11 months)63 PAH patients
- Exposure
- RVFnRec vs no RVFnRec after PAH treatment
- RVFnRecn = 22
- Controlsn = 62
- Outcome
- Definition of RVFnRec: therapeutic CMR changes relative to VO2peak >15 mL/(kg·min), by ROC analysis
- Follow-up
- ≈11 months
Methodological detailsmatched healthy controls (PVDOMICS)
- Matched healthy controls (PVDOMICS)
Main finding
As reported in the abstract
RV end-diastolic volume drop defining RVFnRec
RVFnRec
35%
22
- Drop in right ventricular (RV) end-diastolic volume of −15 mL best defined RVFnRec, AUC
- 0.87
- P value
- P = 0.0001
Observational data: associations, not effects.
Further findings
| Outcome | RVFnRec | No RVFnRec | P value |
|---|---|---|---|
| Clinical worseningRVFnRec vs No RVFnRec · 1 out of 21 vs 17 out of 42 | 5% | 40% | P = 0.006 |
Increase in compliance predicting RVFnRec
- Therapy-associated increase of 0.8 mL/mm Hg in compliance, AUC
- 0.76
- 95% CI
- 0.64-0.88
- P value
- P = 0.001
Stroke volume and cardiac output at exercise
- RVFnRec patients had greater increases in stroke volume and cardiac output at exercise
Original publication
Classification and Predictors of Right Ventricular Functional Recovery in Pulmonary Arterial Hypertension. Circ Heart Fail. Published 4 September 2023. doi:10.
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