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Table 3 Univariate and multivariable linear regression analyses for determinants of right ventricular (RV) dysfunction, RV remodelling, and exercise capacity in healthy controls and pulmonary arterial hypertension (PAH) patients

From: Right ventricular energetic biomarkers from 4D Flow CMR are associated with exertional capacity in pulmonary arterial hypertension

 

Univariate analysis

Stepwise multivariable analysis

Coefficient (95% CI)

P value

Coefficient (95% CI)

P value

Determinants of RV function (RVEF)

 RA area, cm2

− 0.619 (− 0.839, − 0.398)

< 0.001

–

0.348

 TAPSE, mm

1.362 (0.900, 1.823)

< 0.001

–

0.514

 RV GLS, %

1.430 (1.136, 1.723)

< 0.001

0.596 (0.281, 0.911)

< 0.001

 RV direct flow, %

0.820 (0.686, 0.954)

< 0.001

0.587 (0.426, 0.748)

< 0.001

 RV retained inflow, %

0.076 (− 0.404, 0.556)

0.754

Excluded

 

 RV delayed ejection flow, %

0.208 (− 0.310, 0.726)

0.428

Excluded

 

 RV residual volume, %

− 0.649 (− 0.779, − 0.519)

< 0.001

–

0.378

 RV peak systolic KEiEDV, µJ/ml

0.370 (0.141, 0.600)

0.002

0.198 (0.061, 0.336)

0.005

 RV average systolic KEiEDV, µJ/ml

0.747 (0.278, 1.216)

0.002

–

0.802

 RV peak E–wave KEiEDV, µJ/ml

0.048 (− 0.207, 0.303)

0.710

Excluded

 

 KE discordance

9.393 (5.136, 13.65)

< 0.001

–

0.846

 Fractional flow ratio

11.964 (9.129, 14.80)

< 0.001

–

0.118

 R–squared, multivariable

   

0.698

Determinants of adverse RV remodelling (Ln(RVEDV/LVEDV))*

 RVEF, %

− 0.025 (− 0.033, − 0.017)

< 0.001

–

0.997

 RA area, cm2

0.042 (0.034, 0.050)

< 0.001

0.017 (0.011, 0.023)

< 0.001

 TAPSE, mm

− 0.051 (− 0.073, − 0.028)

< 0.001

− 0.019 (− 0.031, − 0.007)

0.002

 RV GLS, %

− 0.049 (− 0.065, − 0.033)

< 0.001

–

0.520

 RV direct flow, %

− 0.030 (− 0.038, − 0.022)

< 0.001

− 0.008 (− 0.013, − 0.002)

0.007

 RV retained inflow, %

0.006 (− 0.016, 0.028)

0.589

Excluded

 

 RV delayed ejection flow, %

0.005 (− 0.019, 0.028)

0.703

Excluded

 

 RV residual volume, %

0.021 (0.014, 0.028)

< 0.001

–

0.385

 RV peak systolic KEiEDV, µJ/ml

0.003 (− 0.008, 0.014)

0.628

Excluded

 

 RV average systolic KEiEDV, µJ/ml

0.015 (–0.008, 0.037)

0.196

Excluded

 

 RV peak E–wave KEiEDV, µJ/ml

0.008 (− 0.004, 0.019)

0.201

Excluded

 

 KE discordance

− 0.129 (− 0.342, 0.083)

0.231

Excluded

 

 Fractional flow ratio

− 0.393 (− 0.544, − 0.241)

< 0.001

–

0.096

 R–squared, multivariable

   

0.588

Determinants of exercise capacity (Ln(% predicted peak VO2))*

 RVEF, %

0.021 (0.014, 0.028)

< 0.001

–

0.228

 RA area, cm2

− 0.018 (− 0.028, − 0.008)

0.001

–

0.418

 TAPSE, mm

0.055 (0.036, 0.074)

< 0.001

0.035 (0.014, 0.055)

0.001

 RV GLS, %

0.036 (0.021, 0.051)

< 0.001

–

0.096

 RV direct flow, %

0.023 (0.015, 0.030)

< 0.001

0.016 (0.008, 0.024)

< 0.001

 RV retained inflow, %

− 0.006 (− 0.025, 0.014)

0.578

Excluded

 

 RV delayed ejection flow, %

0.019 (− 0.002, 0.040)

0.073

Excluded

 

 RV residual volume, %

− 0.019 (− 0.025, − 0.012)

< 0.001

–

0.209

 RV peak systolic KEiEDV, µJ/ml

− 0.003 (− 0.013, 0.007)

0.553

Excluded

 

 RV average systolic KEiEDV, µJ/ml

− 0.002 (− 0.023, 0.018)

0.823

Excluded

 

 RV peak E–wave KEiEDV, µJ/ml

− 0.007 (− 0.018, 0.003)

0.164

Excluded

 

 KE discordance

0.245 (0.060, 0.430)

0.010

–

0.753

 Fractional flow ratio

0.331 (0.193, 0.470)

< 0.001

–

0.641

 R–squared, multivariable

   

0.361

  1. Bold values indicated a statistical significance at P<0.05
  2. CI confidence interval, RVEF right ventricular ejection fraction, RA right atrial, TAPSE tricuspid annular plane systolic excursion, GLS global longitudinal strain, EDV end-diastolic volume, KEiEDV kinetic energy normalized to end-diastolic volume, KE discordance RV/LV average systolic KEiEDV, fractional flow ratio RV direct flow/RV residual volume, RVEDV right ventricular end-diastolic volume, LVEDV left ventricular end-diastolic volume, LV left ventricle, VO2 oxygen uptake. *Based on natural log-transformed (Ln) values to ensure normal distributed residual errors