Evidence map›Paper›PMID 29969067›Full record

ArticleRadiology2018

Identifying At-Risk Patients with Combined Pre- and Postcapillary Pulmonary Hypertension Using Interventricular Septal Angle at Cardiac MRI.

Christopher S Johns, James M Wild, Smitha Rajaram, Euan Tubman, David Capener, Charlie Elliot, Robin Condliffe, Athanasios Charalampopoulos, David G Kiely, Andrew J Swift

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 34 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Review
  5. Article
  6. Article
  7. Clinical-imaging-pathological correlation in pulmonary hypertension associated with left heart disease.European respiratory review : an official journal of the European Respiratory Society · 2024
    Article
  8. Review
  9. Review
  10. Review
  11. Clinical Application of 4D Flow MR Imaging to Pulmonary Hypertension.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2022
    Review
  12. Article
  13. Article
  14. Article
  15. Cardiac Magnetic Resonance in Pulmonary Hypertension-an Update.Current cardiovascular imaging reports · 2020
    Review
  16. Article
  17. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Christopher S JohnsFrom the Academic Department of Radiology, Academic Unit of Radiology, Department of Infection, Immunity & Cardiovascular Disease, Magnetic Resonance Imaging Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Rd, Floor C, Sheffield S10 2JF, England (C.S.J., J.M.W., E.T., D.C., A.J.S.); Sheffield Pulmonary Vascular Disease Institute (C.E., R.C., A.C., D.G.K.) and Department of Radiology (S.R.), Sheffield Teaching Hospitals, Sheffield, England; and Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, England (A.J.S.).ORCID 0000-0003-3724-0430
James M WildFrom the Academic Department of Radiology, Academic Unit of Radiology, Department of Infection, Immunity & Cardiovascular Disease, Magnetic Resonance Imaging Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Rd, Floor C, Sheffield S10 2JF, England (C.S.J., J.M.W., E.T., D.C., A.J.S.); Sheffield Pulmonary Vascular Disease Institute (C.E., R.C., A.C., D.G.K.) and Department of Radiology (S.R.), Sheffield Teaching Hospitals, Sheffield, England; and Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, England (A.J.S.).
Smitha RajaramFrom the Academic Department of Radiology, Academic Unit of Radiology, Department of Infection, Immunity & Cardiovascular Disease, Magnetic Resonance Imaging Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Rd, Floor C, Sheffield S10 2JF, England (C.S.J., J.M.W., E.T., D.C., A.J.S.); Sheffield Pulmonary Vascular Disease Institute (C.E., R.C., A.C., D.G.K.) and Department of Radiology (S.R.), Sheffield Teaching Hospitals, Sheffield, England; and Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, England (A.J.S.).
Euan TubmanFrom the Academic Department of Radiology, Academic Unit of Radiology, Department of Infection, Immunity & Cardiovascular Disease, Magnetic Resonance Imaging Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Rd, Floor C, Sheffield S10 2JF, England (C.S.J., J.M.W., E.T., D.C., A.J.S.); Sheffield Pulmonary Vascular Disease Institute (C.E., R.C., A.C., D.G.K.) and Department of Radiology (S.R.), Sheffield Teaching Hospitals, Sheffield, England; and Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, England (A.J.S.).
David CapenerFrom the Academic Department of Radiology, Academic Unit of Radiology, Department of Infection, Immunity & Cardiovascular Disease, Magnetic Resonance Imaging Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Rd, Floor C, Sheffield S10 2JF, England (C.S.J., J.M.W., E.T., D.C., A.J.S.); Sheffield Pulmonary Vascular Disease Institute (C.E., R.C., A.C., D.G.K.) and Department of Radiology (S.R.), Sheffield Teaching Hospitals, Sheffield, England; and Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, England (A.J.S.).
Charlie ElliotFrom the Academic Department of Radiology, Academic Unit of Radiology, Department of Infection, Immunity & Cardiovascular Disease, Magnetic Resonance Imaging Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Rd, Floor C, Sheffield S10 2JF, England (C.S.J., J.M.W., E.T., D.C., A.J.S.); Sheffield Pulmonary Vascular Disease Institute (C.E., R.C., A.C., D.G.K.) and Department of Radiology (S.R.), Sheffield Teaching Hospitals, Sheffield, England; and Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, England (A.J.S.).
Robin CondliffeFrom the Academic Department of Radiology, Academic Unit of Radiology, Department of Infection, Immunity & Cardiovascular Disease, Magnetic Resonance Imaging Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Rd, Floor C, Sheffield S10 2JF, England (C.S.J., J.M.W., E.T., D.C., A.J.S.); Sheffield Pulmonary Vascular Disease Institute (C.E., R.C., A.C., D.G.K.) and Department of Radiology (S.R.), Sheffield Teaching Hospitals, Sheffield, England; and Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, England (A.J.S.).
Athanasios CharalampopoulosFrom the Academic Department of Radiology, Academic Unit of Radiology, Department of Infection, Immunity & Cardiovascular Disease, Magnetic Resonance Imaging Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Rd, Floor C, Sheffield S10 2JF, England (C.S.J., J.M.W., E.T., D.C., A.J.S.); Sheffield Pulmonary Vascular Disease Institute (C.E., R.C., A.C., D.G.K.) and Department of Radiology (S.R.), Sheffield Teaching Hospitals, Sheffield, England; and Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, England (A.J.S.).
David G KielyFrom the Academic Department of Radiology, Academic Unit of Radiology, Department of Infection, Immunity & Cardiovascular Disease, Magnetic Resonance Imaging Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Rd, Floor C, Sheffield S10 2JF, England (C.S.J., J.M.W., E.T., D.C., A.J.S.); Sheffield Pulmonary Vascular Disease Institute (C.E., R.C., A.C., D.G.K.) and Department of Radiology (S.R.), Sheffield Teaching Hospitals, Sheffield, England; and Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, England (A.J.S.).
Andrew J SwiftFrom the Academic Department of Radiology, Academic Unit of Radiology, Department of Infection, Immunity & Cardiovascular Disease, Magnetic Resonance Imaging Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Rd, Floor C, Sheffield S10 2JF, England (C.S.J., J.M.W., E.T., D.C., A.J.S.); Sheffield Pulmonary Vascular Disease Institute (C.E., R.C., A.C., D.G.K.) and Department of Radiology (S.R.), Sheffield Teaching Hospitals, Sheffield, England; and Insigneo Institute for In Silico Medicine, University of Sheffield, Sheffield, England (A.J.S.).
Royal Hallamshire Hospital · GB

Funding

British Heart Foundation SP/14/6/31350Department of Health NIHR-RP-R3-12-027Medical Research Council MC_PC_16058Medical Research Council MR/M008894/1Wellcome TrustWellcome Trust 205188/Z/16/Z
6 · The paper itself

Abstract

Purpose To assess interventricular septal (IVS) angle in the identification of combined pre- and postcapillary pulmonary hypertension (Cpc-PH) in patients with pulmonary hypertension (PH) due to left-sided heart disease. Materials and Methods In this retrospective study, consecutive, incident patients suspected of having PH underwent same-day right-sided heart catheterization (RHC) and MRI at a PH referral center between April 2012 and April 2017. The diagnostic accuracy of the IVS angle to identify Cpc-PH in patients with pulmonary arterial wedge pressure (PAWP) greater than 15 mmHg was assessed by using receiver operator characteristic curves, sensitivity, specificity, and negative and positive predictive values. IVS angle also was assessed as a predictor of all-cause mortality by using Cox uni- and multivariable proportional hazards regression. Results A total of 708 patients underwent same-day MRI and RHC, and 171 patients had PAWP greater than 15 mmHg. Mean age was 70 years (range, 21-90 years) (women: mean age, 69 years; range, 21-88 years) (men: mean age, 71 years; range, 43-90 years). Systolic IVS angle correlated with diastolic pulmonary gradient (DPG) (r = 0.739, P < .001). Receiver operating characteristic curve analysis showed septal angle enabled identification of Cpc-PH (DPG ≥ 7), with an area under the receiver operating characteristic curve of 0.911 (P < .001). A 160° threshold, derived from the first half of patients with raised PAWP, enabled identification of a DPG of at least 7 mmHg with 67% sensitivity and 93% specificity (P < .001) in the second cohort of patients with raised PAWP. IVS angle was predictive of all-cause mortality (standardized univariable hazard ratio, 1.615; P < .01). Conclusion The systolic interventricular septal angle is elevated in patients with combined pre- and postcapillary pulmonary hypertension and enables one to predict those patients who have PH due to left-sided heart disease who have an increased risk of death. Published under a CC BY 4.0 license. Online supplemental material is available for this article.

Indexed as

AdultAgedAged, 80 and overFemaleHeart FailureHeart SeptumHumansHypertension, PulmonaryImage Interpretation, Computer-AssistedMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesRiskROC CurveYoung Adult

Identifiers

PMID29969067
PMCPMC6190488
OpenAlexW2809839709

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.