@article{Attard:2019:ehjci/jey175,
author = {Attard, M and Dawes, T and Simoes, Monteiro de Marvao A and Biffi, C and Shi, W and Wharton, J and Rhodes, C and Ghataorhe, P and Gibbs, J and Howard, L and Rueckert, D and Wilkins, M and O'Regan, D},
doi = {ehjci/jey175},
journal = {EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging},
pages = {668--676},
title = {Metabolic pathways associated with right ventricular adaptation to pulmonary hypertension: Three dimensional analysis of cardiac magnetic resonance imaging},
url = {http://dx.doi.org/10.1093/ehjci/jey175},
volume = {20},
year = {2019}
}

Download

TY  - JOUR
AB  - AimsWe 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 and resultsIn 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 (β = 0.29) and reduced relative wall thickness (β = −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 (β = 0.28–0.34) including increased levels of tRNA-specific modified nucleosides and fatty acid acylcarnitines, and decreased levels (β = −0.40) of sulfated androgen.ConclusionUsing computational image phenotyping, we identify metabolic profiles, reporting on energy metabolism and cellular stress-response, which are associated with adaptive RV mechanisms to PH.
AU  - Attard,M
AU  - Dawes,T
AU  - Simoes,Monteiro de Marvao A
AU  - Biffi,C
AU  - Shi,W
AU  - Wharton,J
AU  - Rhodes,C
AU  - Ghataorhe,P
AU  - Gibbs,J
AU  - Howard,L
AU  - Rueckert,D
AU  - Wilkins,M
AU  - O'Regan,D
DO  - ehjci/jey175
EP  - 676
PY  - 2019///
SN  - 2047-2412
SP  - 668
TI  - Metabolic pathways associated with right ventricular adaptation to pulmonary hypertension: Three dimensional analysis of cardiac magnetic resonance imaging
T2  - EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging
UR  - http://dx.doi.org/10.1093/ehjci/jey175
UR  - http://hdl.handle.net/10044/1/65817
VL  - 20
ER  - 

Download