TY - JOUR
T1 - Non-invasive estimation of pulmonary vascular resistance with cardiac magnetic resonance
AU - García-Alvarez, Ana
AU - Fernández-Friera, Leticia
AU - Mirelis, Jesús G.
AU - Sawit, Simonette
AU - Nair, Ajith
AU - Kallman, Jill
AU - Fuster, Valentin
AU - Sanz, Javier
N1 - Funding Information:
This work was partially supported by the Centro Nacional de Investi-gaciones Cardiovasculares (CNIC), Madrid, Spain (CARDIOJOVEN Program to A.G.A. and CARDIOIMAGEN to J.G.M.); Instituto de For-mación e Investigación ‘Marqués de Valdecilla’, Santander, Spain (Post-MIR Wenceslao López Albo grant to L.F.F.) and the Spanish Society of Cardiology (Post-Residency Grant to L.F.F. and A.G.A.).
PY - 2011/10
Y1 - 2011/10
N2 - Aim To develop a cardiac magnetic resonance (CMR) method for non-invasive estimation of pulmonary vascular resistance (PVR). Methods and resultsThe study comprised 100 consecutive patients with known or suspected pulmonary hypertension (PH; 53 ± 16 years, 73 women) who underwent same-day right heart catheterization (RHC) and CMR. Increased PVR was defined from RHC as >3 WU (n 66, 66). From CMR cine and phase-contrast images, right ventricular (RV) volumes and ejection fraction (RVEF), pulmonary artery (PA) flow velocities and areas, and cardiac output were quantified. The best statistical model to estimate PVR was obtained from a derivation cohort (n 80) based on physiological plausibility and statistical criteria. Validity of the model was assessed in the remaining 20 patients (validation cohort). The CMR-derived model was: estimated PVR (in WU) 19.38-[4.62 × Ln PA average velocity (in cm/s)]-[0.08 × RVEF (in )]. In the validation cohort, the correlation between invasively quantified and CMR-estimated PVR was 0.84 (P < 0.001). The mean bias between the RHC-derived and CMR-estimated PVR was-0.54 (agreement interval-6.02 to 4.94 WU). The CMR model correctly classified 18 (90) of patients as having normal or increased PVR (area under the receiver operator characteristics curve 0.97; 95 confidence interval: 0.891.00).ConclusionsNon- invasive estimation of PVR using CMR is feasible and may be valuable for PH diagnosis and/or follow-up.
AB - Aim To develop a cardiac magnetic resonance (CMR) method for non-invasive estimation of pulmonary vascular resistance (PVR). Methods and resultsThe study comprised 100 consecutive patients with known or suspected pulmonary hypertension (PH; 53 ± 16 years, 73 women) who underwent same-day right heart catheterization (RHC) and CMR. Increased PVR was defined from RHC as >3 WU (n 66, 66). From CMR cine and phase-contrast images, right ventricular (RV) volumes and ejection fraction (RVEF), pulmonary artery (PA) flow velocities and areas, and cardiac output were quantified. The best statistical model to estimate PVR was obtained from a derivation cohort (n 80) based on physiological plausibility and statistical criteria. Validity of the model was assessed in the remaining 20 patients (validation cohort). The CMR-derived model was: estimated PVR (in WU) 19.38-[4.62 × Ln PA average velocity (in cm/s)]-[0.08 × RVEF (in )]. In the validation cohort, the correlation between invasively quantified and CMR-estimated PVR was 0.84 (P < 0.001). The mean bias between the RHC-derived and CMR-estimated PVR was-0.54 (agreement interval-6.02 to 4.94 WU). The CMR model correctly classified 18 (90) of patients as having normal or increased PVR (area under the receiver operator characteristics curve 0.97; 95 confidence interval: 0.891.00).ConclusionsNon- invasive estimation of PVR using CMR is feasible and may be valuable for PH diagnosis and/or follow-up.
KW - Cardiac magnetic resonance
KW - Non-invasive estimation
KW - Pulmonary hypertension
KW - Pulmonary vascular resistance
UR - https://www.scopus.com/pages/publications/80052937549
U2 - 10.1093/eurheartj/ehr173
DO - 10.1093/eurheartj/ehr173
M3 - Article
C2 - 21624902
AN - SCOPUS:80052937549
SN - 0195-668X
VL - 32
SP - 2438
EP - 2445
JO - European Heart Journal
JF - European Heart Journal
IS - 19
ER -