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Metabolic pathways associated with right ventricular adaptation to pulmonary hypertension: 3D analysis of cardiac magnetic resonance imaging

Attard M, Dawes TJW, De Marvao A, Biffi C, Shi W, Wharton J, Rhodes CJ, Ghataorhe P, Gibbs JSR, Howard LSGE, Rueckert D, Wilkins MR, O'Regan DP (2019)

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Publication Type: Journal article

Publication year: 2019

Journal

Book Volume: 20

Pages Range: 668-676

Journal Issue: 6

DOI: 10.1093/ehjci/jey175

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 and results: 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 (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. 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.

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How to cite

APA:

Attard, M., Dawes, T.J.W., De Marvao, A., Biffi, C., Shi, W., Wharton, J.,... O'Regan, D.P. (2019). Metabolic pathways associated with right ventricular adaptation to pulmonary hypertension: 3D analysis of cardiac magnetic resonance imaging. European Heart Journal - Cardiovascular Imaging, 20(6), 668-676. https://doi.org/10.1093/ehjci/jey175

MLA:

Attard, Mark, et al. "Metabolic pathways associated with right ventricular adaptation to pulmonary hypertension: 3D analysis of cardiac magnetic resonance imaging." European Heart Journal - Cardiovascular Imaging 20.6 (2019): 668-676.

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