Jean-Francois Deux, Lindsey A. Crowe, Leon Genecand, Anne-Lise Hachulla, Carl G. Glessgen, Stephane Noble, Maurice Beghetti, Jin Ning, Daniel Giese, Frederic Lador, Jean-Paul Vallee
Geneva University Hospital. University of Geneva. Centre Universitaire Romand de Cardiologie et Chirurgie Cardiaque Pédiatrique. Siemens Medical Solutions. Siemens Healthcare GmbH
Switzerland, United States and Germany
Journal of Clinical Medicine
J Clin Med 2022; 11:
DOI: 10.3390/jcm11175237
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the causes of pulmonary hypertension (PH) and requires invasive measurement of the mean pulmonary artery pressure (mPAP) during right heart catheterisation (RHC) for the diagnosis. 4D flow MRI could provide non-invasive parameters to estimate the mPAP. Twenty-five patients with suspected CTEPH underwent cardiac MRI. Mean vortex duration (%), pulmonary distensibility, right ventricular volumes and function were measured using 4D flow MRI and cine sequences, and compared with the mPAP measured by RHC. The mPAP measured during RHC was 33 ± 16 mmHg (10-66 mmHg). PH (defined as mPAP > 20 mmHg) was present in 19 of 25 patients (76%). A vortical flow was observed in all but two patients (92%) on 4D flow images, and vortex duration showed good correlation with the mPAP (r = 0.805; p < 0.0001). Youden index analysis showed that a vortex duration of 8.6% of the cardiac cycle provided a 95% sensitivity and an 83% specificity to detect PH. Reliability for the measurement of vortex duration was excellent for both intra-observer ICC = 0.823 and inter-observer ICC = 0.788. Vortex duration could be a useful parameter to non-invasively estimate mPAP in patients with suspected CTEPH.
Category
Class IV. Pulmonary Hypertension Associated with Thromboembolic Disease
Diagnostic Testing for Pulmonary Vascular Disease. Non-invasive Testing
Age Focus: Pediatric Pulmonary Vascular Disease or Adult Pulmonary Vascular Disease
Fresh or Filed Publication: Filed (PHiled). Greater than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes