Abstract
Results As compared to Group 1, MPA of Group 2 and 3 showed larger cross-sectional area (P<0.001), decreased distensibility (P=0.001), slower flow velocity (P<0.001), faster PWV (p=0.005), with more (P<0.001) and longer duration (P=0.030) of vortex and higher PVR (P<0.001). (Table). Compared to Group 2, Group 3 had lower flow rate (P=0.002), shorter accelerative time (P=0.003) and higher PVR (P=0.018).(Table). With multiple linear regression model, we found that vortex (number and duration) and PWV of MPA predicted well of meanPAP in Group 3 (R=0.821), while only moderately in Group 2 (R=0.625). With adding the distensibility of MPA, the prediction of mean PAP improved significantly (R=0.625 to 0.978) in Group 2, while only marginally in Group 3 (R=0.821 to 0.873). Conclusions
Highlights
Phase-contrast MR (PC-MR) is able to show the hemodynamic features of pulmonary artery hypertension (PAH) in comparison to normal subjects
Data analysis was performed by Flow Quantification Analysis (MedVoxel, Vancouver, CA) for area and distensibility, flow rate and velocity, accelerative time and pulse wave velocity (PWV)
With multiple linear regression model, we found that vortex and PWV of MPA predicted well of mean pulmonary artery pressure (meanPAP) in Group 3 (R=0.821), while only moderately in Group 2 (R=0.625)
Summary
Total 68 subjects were enrolled, including: Group 1, 19 normal control (38.5±16 years old, M/F=2/17); Group 2, 15 high-flow type PAH, related to untreated simple congenital heart disease (39.7±17.9 years old, M/F=4/11) and Group 3, 34 high-resistance type PAH (47.9±18.5 years old, M/F=6/28), including idiopathic PAH (N=15) and SLE-related PAH (N=19). 2D and 3D PCMR on the cross-section and 4D PC-MR on longitudinal axis of main pulmonary artery were performed. Data analysis was performed by Flow Quantification Analysis (MedVoxel, Vancouver, CA) for area and distensibility, flow rate and velocity, accelerative time and pulse wave velocity (PWV). An institute- developed program via MatLabTM and tecplotTM was used for visualization and quantification of the number and duration of vortex, and the pressure gradient and pulmonary vascular resistance (PVR). Echocardiography estimated pulmonary artery pressure gradient (echoPASP) were performed for all subjects. Right heart catheterization for mean pulmonary artery pressure (meanPAP) was performed for Group 2 and 3 within 3 months of PC-MR
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