期刊
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
卷 52, 期 11, 页码 -出版社
WILEY
DOI: 10.1111/eci.13835
关键词
cardiac magnetic resonance imaging; children; echocardiography; heart failure; pulmonary hypertension; right ventricle
资金
- Projekt DEAL
This study aimed to validate the EPPVDN pediatric PH risk score and found strong correlations between CMR and echocardiographic variables with the risk score. By developing a web application, the score can be easily accessed and applied in larger pediatric PH studies.
Objectives In 2019, the European Paediatric Pulmonary Vascular Disease Network (EPPVDN) developed a PH risk score to assess the risk and severity of pulmonary hypertension (PH) in children and young adults. We conducted a prospective observational study to validate the EPPVDN paediatric PH risk score by means of cardiac magnetic resonance imaging (CMR) and echocardiography. Methods During the same inpatient stay, the invasive and noninvasive EPPVDN PH risk scores were determined, and a protocol-driven CMR study was performed on 20 PAH children. Subsequently, we correlated the risk scores with imaging variables derived from CMR and echocardiography, including strain. Further, we applied the risk score to nine children with PAH who received add-on selexipag therapy. Before and approximately six months after selexipag start, the risk score and echocardiographic RV strain were determined and delta changes of both were correlated. Results We found strong correlations of conventional CMR (r = 0.69-0.88), CMR strain (r = 0.71-0.88), advanced echocardiographic (r = 0.65-0.88) and echocardiographic strain variables (r = 0.67-0.86) with the EPPVDN PH risk scores (p < .006). In the selexipag cohort, the change in echo-derived RV free wall strain correlated well with the change in the invasive higher risk score (r = 0.72, p = .028). Conclusions We demonstrate strong correlations of outcome-relevant CMR and echocardiographic variables with the EPPVDN PH risk scores, and thus validated the score via independent methods. To achieve broad and easy access, we developed a calculator for the risk score as a web application (). The novel EPPVDN PH risk score will be useful in routine clinical care and can now be applied in larger paediatric PH studies.
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