{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T16:56:05Z","timestamp":1755795365525,"version":"3.44.0"},"reference-count":22,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,6,22]],"date-time":"2025-06-22T00:00:00Z","timestamp":1750550400000},"content-version":"unspecified","delay-in-days":172,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/X020924\/1"],"award-info":[{"award-number":["MR\/X020924\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["205188\/Z\/16\/Z","220703\/Z\/20\/Z"],"award-info":[{"award-number":["205188\/Z\/16\/Z","220703\/Z\/20\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000276","name":"UK Department of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001349","name":"National Medical Research Council Singapore","doi-asserted-by":"crossref","award":["NMRC\/OFIRG\/2016\/0018"],"award-info":[{"award-number":["NMRC\/OFIRG\/2016\/0018"]}],"id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2025,5,7]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Right atrial pressure (RAP) is a key variable that cardiac MRI (CMR) cannot currently measure. We aimed to develop a model to estimate mean RAP (mRAP) using CMR and assess the prognostic value of CMR-derived mRAP in an independent patient cohort.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The derivation cohort consisted of patients investigated for heart failure symptoms with right heart catheterisation and CMR. Right atrial and ventricular CMR measurements were correlated with invasive mRAP to inform multivariable linear regression models incorporating patient characteristics. CMR-derived mRAP was tested as a predictor for clinical outcomes (lower-limb oedema, heart failure hospitalisation and all-cause mortality) on an independent cohort of patients receiving CMR. Both cohorts were derived from hospital registries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In the derivation cohort (n=672), invasive mRAP was &gt;8\u2009mm Hg in 56% of patients. Right atrial end-systolic volume (RAESV) had the strongest correlation with invasive mRAP (Pearson\u2019s coefficient 0.58, p&lt;0.01). RAESV was as accurate as more complex models for mRAP prediction (p&gt;0.05). CMR-derived mRAP \u226510\u2009mm Hg was better associated with outcomes than mRAP \u22658\u2009mm Hg in the clinical cohort (n=101) with diagnostic power for peripheral oedema (area under the curve (AUC) 0.75, p=0.02) and heart failure hospitalisation (AUC 0.93, p&lt;0.01). Kaplan-Meier analysis demonstrated elevated CMR-derived mRAP (\u226510\u2009mm Hg) was associated with reduced survival compared with mRAP &lt;10\u2009mm Hg (\u03c7<jats:sup>2<\/jats:sup>=5, p=0.02) over a mean follow-up of 6.8 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>mRAP can be estimated by CMR. Raised CMR-derived mRAP is predictive of lower-limb oedema, heart failure hospitalisation and all-cause mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2025-003216","type":"journal-article","created":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T03:55:25Z","timestamp":1750650925000},"page":"e003216","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiac MRI-derived mean right atrial pressure and its prognostic importance"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7987-9948","authenticated-orcid":false,"given":"Tom Alexander Howard","family":"Newman","sequence":"first","affiliation":[{"name":"Division of Clinical Medicine, The University of Sheffield School of Medicine and Population Health, Sheffield, UK"},{"name":"Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"},{"name":"NIHR Biomedical Research Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gareth","family":"Matthews","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"},{"name":"Department of Cardiovascular and Metabolic Health, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hosamadin","family":"Assadi","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"},{"name":"Department of Cardiovascular and Metabolic Health, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0006-818X","authenticated-orcid":false,"given":"Rui","family":"Li","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"},{"name":"Department of Cardiovascular and Metabolic Health, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciaran","family":"Grafton-Clarke","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"},{"name":"Department of Cardiovascular and Metabolic Health, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zia","family":"Mehmood","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahman","family":"Kasmai","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"},{"name":"Department of Cardiovascular and Metabolic Health, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Sawh","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"},{"name":"Department of Cardiovascular and Metabolic Health, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Zhong","sequence":"additional","affiliation":[{"name":"National Heart Centre Singapore, Singapore"},{"name":"Medical School, Duke-National University of Singapore, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samer","family":"Alabed","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, The University of Sheffield School of Medicine and Population Health, Sheffield, UK"},{"name":"Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"},{"name":"NIHR Biomedical Research Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joao L","family":"Cavalcante","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute, Minneapolis, Minnesota, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross J","family":"Thomson","sequence":"additional","affiliation":[{"name":"Queen Mary University of London, London, UK"},{"name":"Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nay","family":"Aung","sequence":"additional","affiliation":[{"name":"Queen Mary University of London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob J van der","family":"Geest","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center (LUMC), Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J","family":"Swift","sequence":"additional","affiliation":[{"name":"Division of Clinical Medicine, The University of Sheffield School of Medicine and Population Health, Sheffield, UK"},{"name":"Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"},{"name":"NIHR Biomedical Research Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pankaj","family":"Garg","sequence":"additional","affiliation":[{"name":"Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK"},{"name":"Department of Cardiovascular and Metabolic Health, University of East Anglia, Norwich, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,22]]},"reference":[{"key":"2025081710263558000_12.1.e003216.1","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCIMAGING.117.006984","article-title":"Clinical Utility and Prognostic Value of Right Atrial Function in Pulmonary 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