84 patients underwent lung transplant assessment and CMR, with RV FD assessed using freely available code (FracAnalyse); RV-PA coupling was estimated by stroke volume (SV) / RV end systolic volume (ESV) ratio.
Median follow up was 19.33 ± 17.17 months; 94% of the patients had underlying lung disease. 51 of 66 patients had echo-detected PH. Survival was predicted by SV/ESV, RVEF, indexed RV end-diastolic (EDVi) and ESVi, and mPAP on univariate analysis. Both SV/ESV and RV FD correlated to mPAP, right atrial (RA) area, RVEDVi and RVESVi.
In patients referred for transplant assessment, RV functional adaptation to afterload on CMR predicted survival on univariate analysis. Fractal analysis of RV trabecular complexity correlated with metrics influencing RV remodelling and contractility.