Right ventricular wall hypertrophy predicts functional capacity in pulmonary hypertension. A cardiac magnetic resonance study

Abstract

Purpose: Right ventricular (RV) dilatation and wall hypertrophy is a compensatory mechanism to pressure and volume overload occurring in patients with pulmonary arterial hypertension (PAH). The aim of our study is to investigate the relationship between RV dimensions and wall thickness as accessed with cardiac magnetic resonance (CMR) and distance walked in 6-minute walking test (6MWD) in adult patients with PAH. Methods: All patients underwent 6 minute walking test (6MWT) and CMR on the same day. RV end diastolic (RVEDa) and end systolic area (RVESa) was obtained in short axis at the level of the papillary muscles at end diastole and end systole respectively and RV anterior wall thickness (RVWT) was measured at the same level at end diastole. Results: Our study included 14 patients with PAH (12 women, mean age 46.64±13.4 years), that walked 485.1±108.0 m in 6MWT. After controlling for confounding parameters as age, sex and body surface index, a negative correlation between distance walked in 6 minutes and RVWT (r=-0.671, p<0.001), RVESa (r=-0.660, p<0.01) and RVEDa (r=-0.704, p<0.005) was observed. Multivariate regression analysis showed that only RVWT is an independent predictor of 6MWD (B=-0.267, p<0.05) in the studied population (Table). View this table: Conclusions: The degree of RV hypertrophy may be used as a predictor of functional capacity of patients with PAH.