Prognostic value of right ventricular mass, volume, and function in idiopathic pulmonary arterial hypertension

Eur Heart J. 2007 May;28(10):1250-7. doi: 10.1093/eurheartj/ehl477. Epub 2007 Jan 22.


Aims: This study investigated the relationship between right ventricular (RV) structure and function and survival in idiopathic pulmonary arterial hypertension (IPAH).

Methods and results: In 64 patients, cardiac magnetic resonance, right heart catheterization, and the six-minute walk test (6MWT) were performed at baseline and after 1-year follow-up. RV structure and function were analysed as predictors of mortality. During a mean follow-up of 32 months, 19 patients died. A low stroke volume (SV), RV dilatation, and impaired left ventricular (LV) filling independently predicted mortality. In addition, a further decrease in SV, progressive RV dilatation, and further decrease in LV end-diastolic volume (LVEDV) at 1-year follow-up were the strongest predictors of mortality. According to Kaplan-Meier survival curves, survival was lower in patients with an inframedian SV index <or= 25 mL/m(2), a supramedian RV end-diastolic volume index >or= 84 mL/m(2), and an inframedian LVEDV<or=40 mL/m(2).

Conclusions: The RV contains prognostic information in IPAH. A large RV volume, low SV, and a reduced LV volume are strong independent predictors of mortality and treatment failure.

MeSH terms

  • Adult
  • Cardiac Catheterization
  • Exercise Test
  • Female
  • Follow-Up Studies
  • Heart Ventricles / physiopathology
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / mortality*
  • Hypertension, Pulmonary / physiopathology
  • Magnetic Resonance Imaging, Cine
  • Male
  • Prognosis
  • Pulmonary Artery / physiopathology
  • Risk Factors
  • Stroke Volume
  • Survival Analysis
  • Ventricular Dysfunction, Left / diagnosis*
  • Ventricular Dysfunction, Right / diagnosis*