Cardiac MRI in Pulmonary Artery Hypertension: Correlations Between Morphological and Functional Parameters and Invasive Measurements

OBJECTIVES: To compare cardiac MRI with right heart catheterisation in patients with pulmonary hypertension (PH) and to evaluate its ability to assess PH severity.

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.

CONCLUSIONS: Cardiac MRI can help to assess the severity of PH. Cody Kessler Authentic Jersey

PMID: 20094890

Posted in Magnetic Resonance Imaging and tagged , , , , , , .

One Comment

  1. More data is needed to support clinical use of MRI in patients with PAH. The MRI protocol used is relatively short and to the point (30-40 min), which is great although it leaves out some information that would be nice to have such as amount of underlying myocardial fibrosis.

    I really liked the idea of assessing the position of the IVS visually, and using it as one of the main parameters investigated in this study. This is something that is easy to do without requiring a large amount of time post-processing images, and correlating it with important predictive values would make it of very useful.

    It was interesting to me, that at the beginning of the paper they mention the limitation of echo in patients with no detectable doppler jet of tricuspid insufficiency, and no mention was done of how the PC sequences at the TV fared in visualizing TR.

    All in all, this is a very nice paper! The cohort is on the smaller side, and not very inclusive as most patients included had severe underlying PAH.

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