Abstract
Objective
To compare cardiac MRI with right heart catheterisation in patients with pulmonary hypertension (PH) and to evaluate its ability to assess PH severity.
Materials and methods
Forty patients were included. MRI included cine and phase-contrast sequences, study of ventricular function, cardiac cavity areas and ratios, position of the interventricular septum (IVS) in systole and diastole, and flow measurements. We defined four groups according to the severity of PH and three groups according to IVS position: A, normal position; B, abnormal in diastole; C, abnormal in diastole and systole.
Results
IVS position was correlated with pulmonary artery pressures and PVR (pulmonary vascular resistance). Median pulmonary artery pressures and resistance were significantly higher in patients with an abnormal septal position compared with those with a normal position. Correlations were good between the right ventricular ejection fraction and PVR, right ventricular end-systolic volume and PAP, percentage of right ventricular area change and PVR, and diastolic and systolic ventricular area ratio and PVR. These parameters were significantly associated with PH severity.
Conclusion
Cardiac MRI can help to assess the severity of PH.
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Abbreviations
- AT:
-
acceleration time
- CO:
-
cardiac output
- CI:
-
cardiac index
- dP gradient:
-
diastolic pressure gradient between aorta and pulmonary artery (aorta pressure obtained from peripheral superior arterial arm pressure)
- dPAP:
-
diastolic pulmonary artery pressure
- dRVP:
-
diastolic right ventricular pressure
- dLVEI:
-
diastolic left ventricular eccentricity index
- D area ratio:
-
area ratio between right and left ventricle
- ET:
-
ejection time
- HIV:
-
human immunodeficiency virus
- IVS:
-
interventricular septum
- IVC:
-
inferior vena cava
- LV:
-
left ventricle
- LVEF:
-
left ventricular ejection fraction
- LVEV:
-
left ventricular ejection volume
- LVESV and LVEDV:
-
left ventricular end-systolic and end-diastolic volumes
- LVESA and LVEDA:
-
left ventricular end-systolic and end-diastolic areas
- LA:
-
left atrium
- MRI:
-
magnetic resonance imaging
- mPAP:
-
mean pulmonary artery pressure
- Mit E/A ratio:
-
E/A ratio across the mitral valve
- PAEV:
-
pulmonary artery ejection volume
- PAO:
-
pulmonary artery output
- PVR:
-
pulmonary vascular resistance
- PH:
-
pulmonary hypertension
- RHC:
-
right heart catheterisation
- RA:
-
right atrium
- RV:
-
right ventricle
- RVEF:
-
right ventricular ejection fraction
- RVEV:
-
right ventricular ejection volume
- RVEDV:
-
right ventricular end-diastolic volume
- RVESV:
-
right ventricular end-systolic volume
- RVO:
-
right ventricular output
- RVESA and RVEDA:
-
right ventricular end-systolic and end-diastolic areas
- %RVAC:
-
right ventricular area change between diastole and systole in per cent
- RAP:
-
right atrial pressure
- RAA:
-
right atrium surface
- RVWT:
-
right ventricular wall thickness
- sPAP:
-
systolic pulmonary artery pressure
- sRVP:
-
systolic right ventricular pressure
- sP gradient:
-
systolic pressure gradient between aorta and pulmonary artery (aorta pressure obtained from peripheral superior arterial arm pressure)
- sLVEI:
-
systolic left ventricular eccentricity index
- S area ratio:
-
area ratio between right and left ventricles in systole
- Tri E/A ratio:
-
E/A ratio across the tricuspid valve
- Time (ms) between E:
-
time delay between E waves
- Time (ms) between A:
-
time delay between A waves
- WU:
-
Wood’s unit
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Acknowledgments
JPA, BD, VC, and LT collected results, undertook data management and analysed the results. BD and LT carried out right heart catheterisation and patient follow-up. CA carried out statistical analysis. NB-S, AD, PO and HR gave advice in the preparation of the manuscript. JPA, VC and N Crowte participated in the preparation of the manuscript. VC coordinated the study. A Hermant and S Breil (Philips Healthcare) assisted us in the improvement of MRI sequences. We would like to warmly thank our MRI technicians for their important contribution to this work.
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Alunni, JP., Degano, B., Arnaud, C. et al. Cardiac MRI in pulmonary artery hypertension: correlations between morphological and functional parameters and invasive measurements. Eur Radiol 20, 1149–1159 (2010). https://doi.org/10.1007/s00330-009-1664-3
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DOI: https://doi.org/10.1007/s00330-009-1664-3