Serial phase-contrast MRI for prediction of pulmonary hemodynamic changes in patients with pulmonary arterial hypertension

摘要

Pulmonary arterial hypertension (PAH) is a life-threatening chronic disorder of the pulmonary circulation with diverse possible aetiologies [ 1 ]. It is typically a progressive disease, but with variable rates of hemodynamic deterioration in the individual patient. Cardiopulmonary hemodynamic abnormalities represent well established indicators of progression of the disease and have been identified as significant predictors of survival [2,3]. Previous investigations have demonstrated the possibility of using phase-contrast magnetic resonance imaging (PC-MRI) for quantification of blood flow velocities and cross-sectional vessel dimensions in the main pulmonary artery (PA) [4]. PC-MRI has also shown potential for the non-invasive estimation of PA pressures and pulmonary vascular resistance (PVR) [5]. The present study was aimed to characterize in a group of PAH patients the relationship between variations in invasive pulmonary hemodynamics over time and changes in flow velocity and cross-sectional dimensions of the main PA as defined by serial PC-MRI.This retrospective single-center study included PAH patients with serial right-heart catheterization (RHC) and PC-MRI evaluations. A total of 20 non-consecutive patients (16 females [80%]; mean age, 47 +- 12 years) with PAH were identified, including 10 patients with collagen-vascular disease, 3 patients with porto-pulmonary syndrome, 3 patients with human immunodeficiency virus infection and 4 patients with idiopathic PAH. The diagnosis of PAH was defined by RHC as mean PA pressure >25 mm Hg at rest and normal left heart filling pressures (pulmonary capillary wedge pressure <15 mm Hg)