Dr Andrew J. SwiftFAISAL ABDULWAHAB ABDULQADER ALANDEJANI2022-05-282022-05-28https://drepo.sdl.edu.sa/handle/20.500.14154/38819Pulmonary arterial hypertension (PAH) remains a life threatening disease despite the advancement in medical science. Most patients with PAH will develop right ventricular (RV) failure associated with poor prognosis. Predicting the future course of PAH is a key objective for assessing the effectiveness of the treatment and delivering more accurate information to the patient about the progression of the disease. The ejection fraction and volumes of the RV have shown to provide a prognostic value for PAH patients when evaluated by cardiac magnetic resonance imaging (MRI). Cardiac MRI delivers a high reproducibility and accuracy results when evaluating the function and morphology of the RV. Also, it is previously shown that some cardiac MRI parameters can independently predict the mortality in patients with PAH. Cardiac strain analysis with MRI, may have greater prognostic value as information of cardiac chamber wall motion can be assessed over a cardiac cycle rather than from single-time points such as we standard cardiac MRI. The aim of this study was to investigate the prognostic significance of cardiac strain measurements by cardiac MRI in patients with PAH. A total of 163 patients with PAH were identified from Sheffield MRI pulmonary hypertension database from January 2014 to March 2017. All patients had a baseline scan that took place on a 1.5 T GE MRI scanner. MRI-derived biventricular volumetric and four chambers strain measurements were performed and recorded in the database. We found right atrial fractional area change (RA FAC), right atrial global radial strain (RA GRS), and left ventricle endocardial global circumferential (LV ENDOGC) had independent prognostic value for one-year mortality, while right atrial end-systolic area (RA ESA) being independently predictive in the full cohort of this study. Future work will include studying a larger cohort off patients with PAH and assessment of intra-observer, inter-observer and scan-scan reproducibility.en