Non-invasive determination by cardiovascular magnetic resonance of right ventricular-vascular coupling in children and adolescents with pulmonary hypertension
Background:
Pediatric pulmonary hypertension (PH) remains a disease with high morbidity and mortality in children. Understanding ventricular-vascular coupling, a measure of how well matched the ventricular and vascular function are, may elucidate pathway leading to right heart failure. Ventricular vascular coupling ratio (VVCR), comprised of effective elastance (E
a
, index of arterial load) and right ventricular maximal end-systolic elastance (E
es
, index of contractility), is conventionally determined by catheterization. Here, we apply a non-invasive approach to determining VVCR in pediatric subjects with PH.
Methods:
This retrospective study included PH subjects who had a cardiovascular magnetic resonance (CMR) study within 14 days of cardiac catheterization. PH was defined as mean pulmonary artery pressure (mPAP) ≥ 25 mmHg on prior or current catheterization. A non-invasive measure of VVCR was derived from CMR-only (VVCR
m
) and compared to VVCR estimated by catheterization-derived single beat estimation (VVCR
s
). Indexed pulmonary vascular resistance (PVRi) and pulmonary vascular reactivity were determined during the catheterization procedure. Pearson correlation coefficients were calculated between PVRi and VVCR
m
. Receiver operating characteristic (ROC) cur...
Source: Journal of Cardiovascular Magnetic Resonance - Category: Radiology Authors: Uyen TruongSonali PatelVitaly KheyfetsJamie DunningBrian FonsecaAlex BarkerDunbar IvyRobin ShandasKendall Hunter Source Type: research
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