SynthesisJACC. Cardiovascular imaging2021
Cardiac-MRI Predicts Clinical Worsening and Mortality in Pulmonary Arterial Hypertension: A Systematic Review and Meta-Analysis.
Synthesis in JACC. Cardiovascular imaging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 77 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
77 citing papers in PubMed, 4 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Insights from 3D echocardiography: unveiling the prognostic value of RV function in pulmonary hypertension: a systematic review and meta-analysis.The international journal of cardiovascular imaging · 2025Pooled it
- Impact of cardiovascular magnetic resonance-derived right ventricular ejection fraction on adverse outcomes: A robust Bayesian model-averaged meta-analysis.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2024Pooled it
- Pooled it
- The Role of Artificial Intelligence in Predicting Outcomes by Cardiovascular Magnetic Resonance: A Comprehensive Systematic Review.Medicina (Kaunas, Lithuania) · 2022Pooled it
- CORE-PH: A 3-Component Score for Long-Term Mortality Risk in a Pulmonary Arterial Hypertension Cohort.Diagnostics (Basel, Switzerland) · 2026Article
- Role of PET imaging in evaluating right ventricular function and prognosis in pulmonary hypertension.Clinics (Sao Paulo, Brazil) · 2026Review
- Pulmonary ParenchymalJournal of clinical medicine · 2026Article
- Right ventricular longitudinal function is associated with exercise capacity in pre-capillary pulmonary hypertension: a multimodality imaging study.European heart journal. Imaging methods and practice · 2026Article
- ERS Congress 2025: highlights from the Pulmonary Vascular Diseases Assembly.ERJ open research · 2026Article
- Right Ventricular to Left Ventricular (RV/LV) Blood Pool T2 Ratio Is Associated With Invasive Hemodynamics Across Pulmonary Hypertension Subgroups.Pulmonary circulation · 2026Article
- Beyond the right ventricle: left heart involvement in pulmonary arterial hypertension.Heart failure reviews · 2026Review
- Use of Machine-Learning Models to Identify Clinical Features Associated With A Future Clinical Worsening Event in Patients With Pulmonary Arterial Hypertension.Pulmonary circulation · 2026Article
- Assessment of Right Ventricular Adaptability to Pressure Overloading for Critical Therapeutic Decision-Making Processes.Journal of clinical medicine · 2026Review
- Article
- Inactivation of AXL in Cardiac Fibroblasts Alleviates Right Ventricular Remodeling in Pulmonary Hypertension.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- Discovery Beyond the "Undiscovered Country": Re-Exploring the Right Ventricle Through Metabolomics and Cardiac Magnetic Resonance.JACC. Asia · 2026Article
- Echocardiographic Assessment After Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension: Which Parameters Reflect Improved Right Ventricular Function?Pulmonary circulation · 2026Article
- Beyond the right ventricle: assessment of the left ventricular function in pulmonary hypertension.Frontiers in medicine · 2026Review
- Altitude-Related Differences in Biventricular Remodeling and the Clinical Profile of Pulmonary Hypertension: An Exploratory Cardiovascular Magnetic Resonance Study.Journal of the American Heart Association · 2025Article
- Cardiac MRI-derived ventricular-pulmonary arterial coupling predicts outcomes in connective tissue disease-associated pulmonary arterial hypertension patients.European journal of radiology open · 2025Article
17 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issuedCorrection.2021
Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesThis meta-analysis evaluates assessment of pulmonary arterial hypertension (PAH), with a focus on clinical worsening and mortality.
backgroundCardiac magnetic resonance (CMR) has prognostic value in the assessment of patients with PAH. However, there are limited data on the prediction of clinical worsening, an important composite endpoint used in PAH therapy trials.
methodsThe Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Web of Science databases were searched in May 2020. All CMR studies assessing clinical worsening and the prognosis of patients with PAH were included. Pooled hazard ratios of univariate regression analyses for CMR measurements, for prediction of clinical worsening and mortality, were calculated.
resultsTwenty-two studies with 1,938 participants were included in the meta-analysis. There were 18 clinical worsening events and 8 deaths per 100 patient-years. The pooled hazard ratios show that every 1% decrease in right ventricular (RV) ejection fraction is associated with a 4.9% increase in the risk of clinical worsening over 22 months of follow-up and a 2.1% increase in the risk of death over 54 months. For every 1 ml/m
conclusionsThis review confirms CMR as a powerful prognostic marker in PAH in a large cohort of patients. In addition to confirming previous observations that RV function and RV and left ventricular volumes predict mortality, RV function and volumes also predict clinical worsening. This study provides a strong rationale for considering CMR as a clinically relevant endpoint for trials of PAH therapies.
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Registered trials
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.