Abstract
IntroductionTo compare the reproducibility of pulmonary pulse wave velocity (PWV) techniques, and the effects of age and exercise on these.Methods10 young healthy volunteers (YHV) and 20 older healthy volunteers (OHV) with no cardiac or lung condition were recruited. High temporal resolution phase contrast sequences were performed through the main pulmonary arteries (MPAs), right pulmonary arteries (RPAs) and left pulmonary arteries (LPAs), while high spatial resolution sequences were obtained through the MPA. YHV underwent 2 MRIs 6 months apart with the sequences repeated during exercise. OHV underwent an MRI scan with on-table repetition. PWV was calculated using the transit time (TT) and flow area techniques (QA). 3 methods for calculating QA PWV were compared.ResultsPWV did not differ between the two age groups (YHV 2.4±0.3/ms, OHV 2.9±0.2/ms, p=0.1). Using a high temporal resolution sequence through the RPA using the QA accounting for wave reflections yielded consistently better within-scan, interscan, intraobserver and interobserver reproducibility. Exercise did not result in a change in either TT PWV (mean (95% CI) of the differences: −0.42 (−1.2 to 0.4), p=0.24) or QA PWV (mean (95% CI) of the differences: 0.10 (−0.5 to 0.9), p=0.49) despite a significant rise in heart rate (65±2 to 87±3, p<0.0001), blood pressure (113/68 to 130/84, p<0.0001) and cardiac output (5.4±0.4 to 6.7±0.6 L/min, p=0.004).ConclusionsQA PWV performed through the RPA using a high temporal resolution sequence accounting for wave reflections yields the most reproducible measurements of pulmonary PWV.
Highlights
To compare the reproducibility of pulmonary pulse wave velocity (PWV) techniques, and the effects of age and exercise on these
There was a significant difference between the PWV using the right pulmonary arteries (RPAs) and the left pulmonary arteries (LPAs): mean of the differences −0.55 (−1.1 to −0.03), p=0.038
Similar findings were observed with the high spatial resolution sequence with the QATrad produced significantly higher results than the QA3 ( p=0.004) or the QAInv ( p
Summary
To compare the reproducibility of pulmonary pulse wave velocity (PWV) techniques, and the effects of age and exercise on these. ▸ PWV calculation using MRI is a promising technique for the non-invasive measurement of arterial stiffness within the pulmonary circulation. ▸ Pulmonary pulse wave velocity is measured most reproducibly in the right pulmonary artery using a single slice flow area technique. Pulmonary stiffness is increased early in pulmonary hypertension development and is increased even in those with isolated exercise induced pulmonary hypertension.[17 20,21,22] This combination of features suggest pulmonary arterial stiffness as a promising biomarker for detection of early disease and as a potential therapeutic target before end stage arterial remodelling occurs with dire consequences for the failing right ventricle
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