Massimo Imbriaco MD, Presenter: Nothing to Disclose

Giancarlo Messalli MD, Abstract Co-Author: Nothing to Disclose

Guido Carlomagno, Abstract Co-Author: Nothing to Disclose

Luigi Barbuto, Abstract Co-Author: Nothing to Disclose

Michele Altiero, Abstract Co-Author: Nothing to Disclose

Marco Salvatore MD, Abstract Co-Author: Nothing to Disclose

Prognostic stratification in pulmonary arterial hypertension (PAH) currently relies on clinical assessment and invasive hemodynamic measurements. However, right ventricular dilatation and function, assessed by cardiac magnetic resonance (CMR), have been demonstrated to predict survival independent of invasive indices. Soluble ST2 (sST2), a marker of cardiomyocyte stress related to the IL33/IL1-receptor system, increases in heart failure, especially when right ventricular overload is present. Aim of this study was to explore sST2 and IL-33 levels in PAH, and to evaluate their possible correlation with cardiac remodeling as assessed by CMR.

25 patients with PAH of different etiology and severity underwent clinical evaluation, contrast-enhanced CMR and measurement of serum sST2, IL-33 and NT-proBNP (N-terminal fragment of pro-B-type natriuretic peptide) levels. 10 age-matched healthy individuals with a negative echocardiogram served as controls.

PAH patients showed substantially increased sST2 levels compared with healthy controls; circulating IL-33 was detectable in about 70% of subjects, and no difference was found between cases and controls. Patients with sST2 levels above and below the median differed significantly in terms of WHO class, walking distance, right ventricular diastolic and systolic volume indices, and ejection fraction. Analysis of CMR data showed strong correlation of sST2 levels with right-ventricular end-systolic volume and NT-proBNP, as well as a significant negative correlation with right ventricular ejection fraction; myocardial fibrosis was also more represented in patients with higher sST2 levels.  

Right ventricular remodeling, function and myocardial fibrosis assessed by CMR, strongly correlate with sST2 levels in patients with PAH.

Cardiac MRI predicts right ventricular remodeling, function and myocardial fibrosis in patients with PAH; these parameters strongly correlate with sST2 levels, a marker of cardiomyocyte stress.

Imbriaco, M, Messalli, G, Carlomagno, G, Barbuto, L, Altiero, M, Salvatore, M, Cardiac Magnetic Resonance and Right Ventricular Remodeling in Pulmonary Hypertension Patients: Correlation with Biochemical Parameters of Right Ventricular Overload.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12043715.html