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Erschienen in: The International Journal of Cardiovascular Imaging 10/2019

22.06.2018 | Original Paper

Pulmonary arterial stiffness assessed by cardiovascular magnetic resonance imaging is a predictor of mild pulmonary arterial hypertension

verfasst von: Jordan C. Ray, Charles Burger, Patricia Mergo, Robert Safford, Joseph Blackshear, Christopher Austin, DeLisa Fairweather, Michael G. Heckman, Tonya Zeiger, Marcia Dubin, Brian Shapiro

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 10/2019

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Abstract

Early detection of mild pulmonary arterial hypertension (PAH) based on clinical evaluation and echocardiography remains quite challenging. In addition to enhanced right ventricular (RV) assessment, cardiac magnetic resonance (CMR) imaging may accurately reflect deleterious remodeling and increased stiffness of the central pulmonary arteries based on pulsatility, or percent change of the PA during the cardiac cycle. The purpose of this study is to assess the utility of measuring PA pulsatility by CMR as a potential early maker in PAH. We hypothesize that pulsatility may help discriminate mild PAH from normal control subjects. Consecutive patients with PAH (n = 51) were prospectively enrolled to receive same day CMR and right heart catheterization (RHC). PA stiffness indices including pulsatility, distensibility, compliance, and capacitance were calculated. Comparisons were made between patients with varying severities of PAH and normal controls (n = 18). Of the 51 subjects, 20 had mild PAH, and 31 moderate-severe based on hemodynamic criteria. PA pulsatility demonstrated a progressive decline from normal controls (53%), mild PAH (22%), to moderate-severe PAH (17%; p < 0.001). There was no difference in RV size, function or mass between mild PAH and normal controls. PA pulsatility below 40% had an excellent ability to discriminate between mild PAH and normal controls with a sensitivity of 95% and specificity of 94%. CMR assessment of PA stiffness may noninvasively detect adverse pulmonary vascular remodeling and mild PAH, and thus be a valuable tool for early detection of PAH. Trial Registration: ClinicalTrials.gov Identifier: NCT01451255; https://​clinicaltrials.​gov/​ct2/​show/​NCT01451255.
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Metadaten
Titel
Pulmonary arterial stiffness assessed by cardiovascular magnetic resonance imaging is a predictor of mild pulmonary arterial hypertension
verfasst von
Jordan C. Ray
Charles Burger
Patricia Mergo
Robert Safford
Joseph Blackshear
Christopher Austin
DeLisa Fairweather
Michael G. Heckman
Tonya Zeiger
Marcia Dubin
Brian Shapiro
Publikationsdatum
22.06.2018
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 10/2019
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-018-1397-y

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