Metabolic pathways associated with right ventricular adaptation to pulmonary hypertension: 3D analysis of cardiac magnetic resonance imaging.
Eur Heart J Cardiovasc Imaging
; 20(6): 668-676, 2019 Jun 01.
Article
em En
| MEDLINE
| ID: mdl-30535300
ABSTRACT
AIMS:
We sought to identify metabolic pathways associated with right ventricular (RV) adaptation to pulmonary hypertension (PH). We evaluated candidate metabolites, previously associated with survival in pulmonary arterial hypertension, and used automated image segmentation and parametric mapping to model their relationship to adverse patterns of remodelling and wall stress. METHODS ANDRESULTS:
In 312 PH subjects (47.1% female, mean age 60.8 ± 15.9 years), of which 182 (50.5% female, mean age 58.6 ± 16.8 years) had metabolomics, we modelled the relationship between the RV phenotype, haemodynamic state, and metabolite levels. Atlas-based segmentation and co-registration of cardiac magnetic resonance imaging was used to create a quantitative 3D model of RV geometry and function-including maps of regional wall stress. Increasing mean pulmonary artery pressure was associated with hypertrophy of the basal free wall (ß = 0.29) and reduced relative wall thickness (ß = -0.38), indicative of eccentric remodelling. Wall stress was an independent predictor of all-cause mortality (hazard ratio = 1.27, P = 0.04). Six metabolites were significantly associated with elevated wall stress (ß = 0.28-0.34) including increased levels of tRNA-specific modified nucleosides and fatty acid acylcarnitines, and decreased levels (ß = -0.40) of sulfated androgen.CONCLUSION:
Using computational image phenotyping, we identify metabolic profiles, reporting on energy metabolism and cellular stress-response, which are associated with adaptive RV mechanisms to PH.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Disfunção Ventricular Direita
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Imagem Cinética por Ressonância Magnética
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Remodelação Ventricular
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Imageamento Tridimensional
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Hipertensão Pulmonar
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Reino Unido