PULMONARY ARTERY MORPHOLOGY AS A BIOMARKER OF PULMONARY HYPERTENSION

Abstract

As pulmonary hypertension (PH) is associated with poor prognostic and survival outcomes, an early PH diagnosis is crucial for optimal patient care. In this study, we aimed to demonstrate PH induces pulmonary artery (PA) remodeling and alterations in right cardiac function. In this study, 36 PH patients and eight healthy controls were retrospectively assessed for PA remodeling using a 3T MRI scanner standard cardiac imaging protocol including 3D contrast-enhanced magnetic resonance angiography (CE-MRA). Data analysis was performed with CVI42 software (Circle Cardiovascular Imaging Inc., Calgary, Canada) to measure heart function from bi-planar analysis, and PA remodeling via diameter, bifurcation distances, and bifurcation angles (Figure 1). Analysis of bifurcation angles and distances were performed in 20 patients. PH patients demonstrate differences in right ventricular function (Table 1). In addition, PH patients display greater diameters relative to controls in the LPA (AP: p = 0.002, CC: p < 0.001), MPA (AP: p = 0.003, CC: p = 0.001), and RPA (AP: p = 0.001, CC: p < 0.001). PH patients also demonstrated greater bifurcation distances in the MPA (p = 0.027), RPA (p = 0.001), and LPA (p = 0.009). Each AP-CC diameter (p < 0.001 for all), and the RPA bifurcation distance (p = 0.005) demonstrate correlations to the RVEF. This study suggests PA remodeling (PA diameters, bifurcation angles, bifurcation distances) can be used as biomarkers of PH by characterizing disease severity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)