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CMR-based heart deformation analysis for quantification of hemodynamics and right ventricular dysfunction in patients with CTEPH

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单位: [1]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China [2]Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China [3]Department of Radiology, China-Japan Friendship Hospital, Beijing, China
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关键词: cardiovascular magnetic resonance chronic thromboembolic pulmonary hypertension heart deformation analysis hemodynamics right ventricular longitudinal strain right ventricular function

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Introduction Quantification of hemodynamics and right ventricular (RV) function is crucial for pulmonary hypertension (PH). Cardiovascular magnetic resonance-based heart deformation analysis (CMR-HDA) has been used to assess the ventricular strain. Objective This study was to determine the correlation of right ventricular longitudinal strain (RVLS) assessed with CMR-HDA with RV function as well as hemodynamics in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods Thirty-six CTEPH patients were prospectively included in this research. Each patients underwent CMR and right heart catheterization (RHC). RVLS and RV ejection fraction (RVEF) was quantified from cine images acquired with a retrospectively gated turbo FLASH gradient-echo sequence. The late gadolinium enhancement (LGE) images were acquired using a 2D inversion recovery phase-sensitive fast gradient-echo sequence. Hemodynamics were determined with RHC. Results Right ventricular longitudinal strain measured with CMR-HDA was -13.99 +/- 4.94%. Bland-Altman plots showed statistical agreement with RVLS with low intra- and interobserver variability. RVLS correlated with serum N-terminal-pro-B-type natriuretic peptide (r = 0.615, P < .001). RVLS inversely correlated with RVEF (r = -0.699, P < .001), and it was positively correlated with both RVESV (r = 0.664, P < .001) and myocardial the volume of LGE (r = 0.447, P = .008). Receiver-operating characteristic (ROC) indicated that RVLS values of >-14.20% could be used to predict RVEF <40% with a 100% sensitivity and a 96.7% specificity. Hemodynamically, RVLS was positively correlated with mean pulmonary artery pressure (r = 0.598, P < .001) and pulmonary vascular resistance (r = 0.685, P < .001). Conclusion Right ventricular longitudinal strain assessed by CMR-HDA is a readily available and reproducible parameters of RV function. RVLS >-14.20% suggests the presence of RV dysfunction.

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出版当年[2019]版:
大类 | 4 区 医学
小类 | 4 区 呼吸系统
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 呼吸系统
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Q4 RESPIRATORY SYSTEM
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Q3 RESPIRATORY SYSTEM

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第一作者单位: [1]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China [2]Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China
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通讯机构: [1]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China [2]Chinese Academy of Medical Sciences, Graduate School of Peking Union Medical College, Beijing, China [*1]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2 Yinghua Dong Street, Hepingli, Chao Yang District, Beijing 100029, China
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