| Title: |
Four-Dimensional Magnetic Resonance Pulmonary Flow Imaging for Assessing Pulmonary Vasculopathy in Patients with Postcapillary Pulmonary Hypertension. |
| Authors: |
Nuche, Jorge, Ponz, Inés, Sánchez Sánchez, Violeta, Bóbeda, Javier, Gaitán, Ángel, López-Linares, Karen, García-Cosío, María Dolores, Sarnago Cebada, Fernando, González, Javier Sánchez, Arribas Ynsaurriaga, Fernando, Ruíz-Cabello, Jesús, Ibáñez, Borja, Delgado, Juan F. |
| Source: |
Journal of Clinical Medicine; Feb2025, Vol. 14 Issue 3, p929, 17p |
| Subject Terms: |
CARDIAC magnetic resonance imaging, PULMONARY hypertension, SYSTOLIC blood pressure, REYNOLDS number, PULMONARY artery |
| Abstract: |
Background: Noninvasive techniques for diagnosing combined postcapillary pulmonary hypertension (CpcPH) are unavailable. Objective: To assess the diagnostic performance of cardiac magnetic resonance (CMR)-based four-dimensional (4D)-flow analysis in identifying CpcPH. Methods: Prospective observational study of heart failure (HF) patients with suspected pulmonary hypertension (PH) who underwent simultaneous CMR and right heart catheterization. The 4D-flow biomarkers were calculated using an automatic pipeline. A predictive model including 4D-flow biomarkers associated with CpcPH with a p-value < 0.20 was built to determine the diagnostic performance of 4D-flow analysis to identify CpcPH. Results: A total of 46 HF patients (55.4 ± 14 years, 63% male) with confirmed PH (19 [41%] isolated postcapillary PH [IpcPH], 27 [59%] CpcPH) were included. No differences were found in baseline characteristics, echocardiography, or CMR anatomical and functional parameters, except for a higher Doppler-estimated systolic pulmonary pressure and larger pulmonary artery in CpcPH patients. The 4D-flow CMR analysis was performed in 31 patients (67%). The maximal peak velocity (67.1 [62.2–77.5] cm/s—IpcPH vs. 58.2 [45.8–66.0] cm/s—CpcPH; p = 0.021) and maximal helicity (339.9 [290.0–391.8]) cm/s2—IpcPH vs. 226.0 (173.5–343.7) cm/s2—CpcPH; p = 0.026) were significantly lower in patients with CpcPH. A maximal multivariable model including sex, maximal average, and peak velocities, Reynolds number, flow rate, and helicity showed fair diagnostic performance (area under the curve: 0.768 [95%-CI: 0.572–0.963]; sensitivity: 100%; specificity: 55%). Conclusions: In HF patients with PH, 4D-flow-derived maximal peak velocity and maximal helicity were significantly lower in CpcPH patients. A multiparametric model including maximal 4D-flow-derived biomarkers showed good diagnostic performance for identifying CpcPH. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
