Evaluation of Pulmonary Artery Stiffness in Pulmonary Hypertension With Cardiac Magnetic Resonance

Javier Sanz, Mbabazi Kariisa, Santo Dellegrottaglie, Susanna Prat-González, Mario J. Garcia, Valentin Fuster, Sanjay Rajagopalan

Research output: Contribution to journalArticle

180 Citations (Scopus)

Abstract

Objectives: This study sought to evaluate indexes of pulmonary artery (PA) stiffness in patients with pulmonary hypertension (PH) using same-day cardiac magnetic resonance (CMR) and right heart catheterization (RHC). Background: Pulmonary artery stiffness is increased in the presence of PH, although the relationship to PH severity has not been fully characterized. Methods: Both CMR and RHC were performed on the same day in 94 patients with known or suspected PH. According to the RHC, patients were classified as having no PH (n = 13), exercise-induced PH (EIPH) only (n = 6), or PH at rest (n = 75). On CMR, phase-contrast images were obtained perpendicular to the pulmonary trunk. From CMR and RHC data, PA areas and indexes of stiffness (pulsatility, compliance, capacitance, distensibility, elastic modulus, and the pressure-independent stiffness index β) were measured at rest. Results: All quantified indexes showed increased PA stiffness in patients with PH at rest in comparison with those with EIPH or no PH. Despite the absence of significant differences in baseline pressures, patients with EIPH had lower median compliance and capacitance than patients with no PH: 15 (interquartile range: 9 to 19.8) mm2/mm Hg versus 8.4 (interquartile range: 6 to 10.3) mm2/mm Hg, and 5.2 (interquartile range: 4.4 to 6.3) mm3/mm Hg versus 3.7 (interquartile range: 3.1 to 4.1) mm3/mm Hg, respectively (p < 0.05). The different measurements of PA stiffness, including stiffness index β, showed significant correlations with PA pressures (r2 = 0.27 to 0.73). Reduced PA pulsatility (<40%) detected the presence of PH at rest with a sensitivity of 93% and a specificity of 63%. Conclusions: Pulmonary artery stiffness increases early in the course of PH (even when PH is detectable only with exercise and before overt pressure elevations occur at rest). These observations suggest a potential contributory role of PA stiffness in the development and progression of PH.

Original languageEnglish (US)
Pages (from-to)286-295
Number of pages10
JournalJACC: Cardiovascular Imaging
Volume2
Issue number3
DOIs
StatePublished - Mar 2009
Externally publishedYes

Fingerprint

Pulmonary Hypertension
Pulmonary Artery
Magnetic Resonance Spectroscopy
Cardiac Catheterization
Exercise
Pressure
Elastic Modulus
Patient Compliance
Compliance

Keywords

  • cardiac magnetic resonance
  • hypertension
  • pulmonary
  • pulmonary artery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Evaluation of Pulmonary Artery Stiffness in Pulmonary Hypertension With Cardiac Magnetic Resonance. / Sanz, Javier; Kariisa, Mbabazi; Dellegrottaglie, Santo; Prat-González, Susanna; Garcia, Mario J.; Fuster, Valentin; Rajagopalan, Sanjay.

In: JACC: Cardiovascular Imaging, Vol. 2, No. 3, 03.2009, p. 286-295.

Research output: Contribution to journalArticle

Sanz, J, Kariisa, M, Dellegrottaglie, S, Prat-González, S, Garcia, MJ, Fuster, V & Rajagopalan, S 2009, 'Evaluation of Pulmonary Artery Stiffness in Pulmonary Hypertension With Cardiac Magnetic Resonance', JACC: Cardiovascular Imaging, vol. 2, no. 3, pp. 286-295. https://doi.org/10.1016/j.jcmg.2008.08.007
Sanz, Javier ; Kariisa, Mbabazi ; Dellegrottaglie, Santo ; Prat-González, Susanna ; Garcia, Mario J. ; Fuster, Valentin ; Rajagopalan, Sanjay. / Evaluation of Pulmonary Artery Stiffness in Pulmonary Hypertension With Cardiac Magnetic Resonance. In: JACC: Cardiovascular Imaging. 2009 ; Vol. 2, No. 3. pp. 286-295.
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AU - Garcia, Mario J.

AU - Fuster, Valentin

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N2 - Objectives: This study sought to evaluate indexes of pulmonary artery (PA) stiffness in patients with pulmonary hypertension (PH) using same-day cardiac magnetic resonance (CMR) and right heart catheterization (RHC). Background: Pulmonary artery stiffness is increased in the presence of PH, although the relationship to PH severity has not been fully characterized. Methods: Both CMR and RHC were performed on the same day in 94 patients with known or suspected PH. According to the RHC, patients were classified as having no PH (n = 13), exercise-induced PH (EIPH) only (n = 6), or PH at rest (n = 75). On CMR, phase-contrast images were obtained perpendicular to the pulmonary trunk. From CMR and RHC data, PA areas and indexes of stiffness (pulsatility, compliance, capacitance, distensibility, elastic modulus, and the pressure-independent stiffness index β) were measured at rest. Results: All quantified indexes showed increased PA stiffness in patients with PH at rest in comparison with those with EIPH or no PH. Despite the absence of significant differences in baseline pressures, patients with EIPH had lower median compliance and capacitance than patients with no PH: 15 (interquartile range: 9 to 19.8) mm2/mm Hg versus 8.4 (interquartile range: 6 to 10.3) mm2/mm Hg, and 5.2 (interquartile range: 4.4 to 6.3) mm3/mm Hg versus 3.7 (interquartile range: 3.1 to 4.1) mm3/mm Hg, respectively (p < 0.05). The different measurements of PA stiffness, including stiffness index β, showed significant correlations with PA pressures (r2 = 0.27 to 0.73). Reduced PA pulsatility (<40%) detected the presence of PH at rest with a sensitivity of 93% and a specificity of 63%. Conclusions: Pulmonary artery stiffness increases early in the course of PH (even when PH is detectable only with exercise and before overt pressure elevations occur at rest). These observations suggest a potential contributory role of PA stiffness in the development and progression of PH.

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