Noninvasive prediction of pulmonary artery pressure and vascular resistance by using cardiac magnetic resonance indices

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• 作者：Zhang Zhang^a ; ¹ ; Meng Wang^a ; ¹ ; Zhenwen Yang^b ; Fan Yang^a ; Dong Li^a ; Tielian Yu^a ; Ningnannan Zhang^a ; ^{znnn2010@sina.com}
• 关键词：Magnetic resonance imaging ; Pulmonary arterial hypertension ; Pulmonary artery pressure ; Pulmonary vascular resistance
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：15 January 2017
• 年：2017
• 卷：227
• 期：Complete
• 页码：915-922
• 全文大小：1099 K
• 卷排序：227

文摘

Cardiac magnetic resonance (CMR) has promise of being able to provide frequent cardiac morphology and function evaluations noninvasively for repeated follow-ups of pulmonary arterial hypertension (PAH) patients after the initial right heart catheterization (RHC) diagnosis. By using the noninvasive CMR indices, the present study aimed to formulate and validate a prediction model of mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR).MethodsBoth Derivation Cohort (N = 25) and Validation Cohort (N = 25) of PAH patients underwent CMR and RHC within one week. Fast cine and phase-contrast sequences were used to calculate CMR indices, including ventricular mass index (VMI), interventricular septum curvature ratio (CR), and positive pulmonary arterial flow (QP). The gold standard mPAP (mPAPRHC) and PVR (PVRRHC) were measured from RHC. mPAP was calculated using CMR indices (mPAPCMR) from the Derivation Cohort. Multiple linear regression was applied for analysis.ResultsThe equation predicting mPAP was mPAPCMR = 28.837VMI − 26.479CR − 0.201QP + 57.021. The equation was then applied to the Validation Cohort to verify the accuracy of the prediction equation. mPAPCMR was correlated linearly with mPAPRHC as mPAPRHC = 0.8055mPAPCMR + 7.9056 (r2 = 0.6470, p < 0.001). Moreover, PVR calculated from CMR (PVRCMR) was also correlated with the PVRRHC in both the Derivation Cohort (r2 = 0.4092, p < 0.001) and the Validation Cohort (r2 = 0.3480, p < 0.001).ConclusionThe application of the mPAPCMR and PVRCMR technique could potentially provide a noninvasive method to evaluate the hemodynamics for PAH patients during follow-ups as well as right ventricle function assessment.