A non-invasive assessment of cardiopulmonary hemodynamics with MRI in pulmonary hypertension.

Journal Article (Journal Article)

PURPOSE: We propose a method for non-invasive quantification of hemodynamic changes in the pulmonary arteries resulting from pulmonary hypertension (PH). METHODS: Using a two-element Windkessel model, and input parameters derived from standard MRI evaluation of flow, cardiac function and valvular motion, we derive: pulmonary artery compliance (C), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), pulmonary capillary wedge pressure (PCWP), time-averaged intra-pulmonary pressure waveforms and pulmonary artery pressures (systolic (sPAP) and diastolic (dPAP)). MRI results were compared directly to reference standard values from right heart catheterization (RHC) obtained in a series of patients with suspected pulmonary hypertension (PH). RESULTS: In 7 patients with suspected PH undergoing RHC, MRI and echocardiography, there was no statistically significant difference (p<0.05) between parameters measured by MRI and RHC. Using standard clinical cutoffs to define PH (mPAP>25mmHg), MRI was able to correctly identify all patients as having pulmonary hypertension, and to correctly distinguish between pulmonary arterial (mPAP>25mmHg, PCWP<15mmHg) and venous hypertension (mPAP>25mmHg, PCWP>15mmHg) in 5 of 7 cases. CONCLUSIONS: We have developed a mathematical model capable of quantifying physiological parameters that reflect the severity of PH.

Full Text

Duke Authors

Cited Authors

  • Bane, O; Shah, SJ; Cuttica, MJ; Collins, JD; Selvaraj, S; Chatterjee, NR; Guetter, C; Carr, JC; Carroll, TJ

Published Date

  • December 2015

Published In

Volume / Issue

  • 33 / 10

Start / End Page

  • 1224 - 1235

PubMed ID

  • 26283577

Pubmed Central ID

  • PMC4658324

Electronic International Standard Serial Number (EISSN)

  • 1873-5894

Digital Object Identifier (DOI)

  • 10.1016/j.mri.2015.08.005

Language

  • eng

Conference Location

  • Netherlands