Skip to main content
Journal cover image

Prognostic Implications of Mitral Annular Plane Systolic Excursion in Patients with Hypertension and a Clinical Indication for Cardiac Magnetic Resonance Imaging: A Multicenter Study.

Publication ,  Journal Article
Romano, S; Judd, RM; Kim, RJ; Kim, HW; Heitner, JF; Shah, DJ; Devereux, RB; Salazar, P; Trybula, M; Chia, RC; Evans, K; Farzaneh-Far, A
Published in: JACC. Cardiovascular imaging
September 2019

This study sought to evaluate the prognostic value of cardiac magnetic resonance (CMR)-derived mitral annular plane systolic excursion (MAPSE) in a large multicenter population of patients with hypertension.In patients with hypertension, cardiac abnormalities are powerful predictors of adverse outcomes. Long-axis mitral annular movement plays a fundamental role in cardiac mechanics and is an early marker for a number of pathological processes. Given the adverse consequences of cardiac involvement in hypertension, the authors hypothesized that lateral MAPSE may provide incremental prognostic information in these patients.Consecutive patients with hypertension and a clinical indication for CMR at 4 U.S. medical centers were included in this study (n = 1,735). Lateral MAPSE was measured in the 4-chamber cine view. The primary endpoint was all-cause death. Cox proportional hazards regression modeling was used to examine the association between lateral MAPSE and death. The incremental prognostic value of lateral MAPSE was assessed in nested models.Over a median follow-up period of 5.1 years, 235 patients died. By Kaplan-Meier analysis, risk of death was significantly higher in patients with a lateral MAPSE < median (10 mm) (log-rank; p < 0.0001). Lateral MAPSE was associated with risk of death after adjustment for clinical and imaging risk factors (hazard ratio [HR]: 1.402-per-millimeter decrease; p < 0.001). Addition of lateral MAPSE in this model resulted in significant improvement in the C-statistic (0.735 to 0.815; p < 0.0001). Continuous net reclassification improvement was 0.739 (95% confidence interval: 0.601 to 0.902). Lateral MAPSE remained significantly associated with death even after adjustment for feature tracking global longitudinal strain (HR: 1.192-per-millimeter decrease; p < 0.001). Lateral MAPSE was independently associated with death among the subgroups of patients with preserved ejection fraction (HR = 1.339; p < 0.001) and in those without history of myocardial infarction (HR: 1.390; p < 0.001).CMR-derived lateral MAPSE is a powerful, independent predictor of mortality in patients with hypertension and a clinical indication for CMR, incremental to common clinical and CMR risk factors. These findings may suggest a role for CMR-derived lateral MAPSE in identifying hypertensive patients at highest risk of death.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JACC. Cardiovascular imaging

DOI

EISSN

1876-7591

ISSN

1936-878X

Publication Date

September 2019

Volume

12

Issue

9

Start / End Page

1769 / 1779

Related Subject Headings

  • United States
  • Systole
  • Risk Factors
  • Risk Assessment
  • Prognosis
  • Predictive Value of Tests
  • Mitral Valve
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging, Cine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Romano, S., Judd, R. M., Kim, R. J., Kim, H. W., Heitner, J. F., Shah, D. J., … Farzaneh-Far, A. (2019). Prognostic Implications of Mitral Annular Plane Systolic Excursion in Patients with Hypertension and a Clinical Indication for Cardiac Magnetic Resonance Imaging: A Multicenter Study. JACC. Cardiovascular Imaging, 12(9), 1769–1779. https://doi.org/10.1016/j.jcmg.2018.10.003
Romano, Simone, Robert M. Judd, Raymond J. Kim, Han W. Kim, John F. Heitner, Dipan J. Shah, Richard B. Devereux, et al. “Prognostic Implications of Mitral Annular Plane Systolic Excursion in Patients with Hypertension and a Clinical Indication for Cardiac Magnetic Resonance Imaging: A Multicenter Study.JACC. Cardiovascular Imaging 12, no. 9 (September 2019): 1769–79. https://doi.org/10.1016/j.jcmg.2018.10.003.
Romano, Simone, et al. “Prognostic Implications of Mitral Annular Plane Systolic Excursion in Patients with Hypertension and a Clinical Indication for Cardiac Magnetic Resonance Imaging: A Multicenter Study.JACC. Cardiovascular Imaging, vol. 12, no. 9, Sept. 2019, pp. 1769–79. Epmc, doi:10.1016/j.jcmg.2018.10.003.
Romano S, Judd RM, Kim RJ, Kim HW, Heitner JF, Shah DJ, Devereux RB, Salazar P, Trybula M, Chia RC, Evans K, Farzaneh-Far A. Prognostic Implications of Mitral Annular Plane Systolic Excursion in Patients with Hypertension and a Clinical Indication for Cardiac Magnetic Resonance Imaging: A Multicenter Study. JACC Cardiovascular imaging. 2019 Sep;12(9):1769–1779.
Journal cover image

Published In

JACC. Cardiovascular imaging

DOI

EISSN

1876-7591

ISSN

1936-878X

Publication Date

September 2019

Volume

12

Issue

9

Start / End Page

1769 / 1779

Related Subject Headings

  • United States
  • Systole
  • Risk Factors
  • Risk Assessment
  • Prognosis
  • Predictive Value of Tests
  • Mitral Valve
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging, Cine