[The application value of cardiac magnetic resonance quantitative T1 mapping technique for risk stratification in patients with pulmonary arterial hypertension].

Abstract

Objective: To explore the application value of cardiac magnetic resonance (CMR) native T1 mapping for risk stratification in patients with pulmonary arterial hypertension (PAH). Methods: A total of 59 patients with diagnosed PAH and clear-documented risk status in Peking Union Medical College Hospital and underwent CMR examination between January 2019 and December 2021 were retrospectively included, which including 12 males and 47 females, aged from 4 to 77 (31±13) years. Those patients were subdivided into two groups based on the clinically-assessed risk status: low-risk group (n=30) and intermediate-/high-risk group (n=29). Twenty-five healthy individuals were included as controls. Base, midventricular, and apical inferior right ventricular insertion point (IRVIP) native T1 values on short axis images were measured. Native T1 values in PAH patients and control group, in low-risk group and intermediate-/high-risk group were compared, respectively, and receiver operating characteristics (ROC) curves with area under the curves (AUC) were calculated to evaluate the application value of native T1 values for risk stratification in PAH patients. Results: Base, midventricular and apical IRVIP native T1 of PAH patients were all significantly increased as compared to controls [Base:(1 439.31±129.96) vs (1 282.36±37.18) ms;midventricular:(1 450.32±111.55) vs (1 287.56±53.16) ms;apical:(1 444.12±109.15) vs (1 266.36±75.31) ms](all P<0.001). The midventricular IRVIP native T1 values were significantly higher in patients in intermediate-/high-risk status as compared to those in low-risk status [ (1 493.24±126.32) vs (1 428.50±85.73) ms,P=0.026]. The AUC of mid ventricle IRVIP native T1 for distinguishing patients in intermediate-/high-risk status was 0.741. The base [(1 458.21±134.96) vs (1 421.03±104.75) ms, P=0.241] and apical [(1 465.90±125.36) vs (1 423.07±87.87) ms,P=0.136] IRVIP native T1 values in patients in intermediate-/high-risk group were also numerically higher as compared with patients in low-risk status, however, without statistical significant (both P>0.05). Conclusion: Midventricular IRVIP native T1 value might have a role for assisting in risk stratification in PAH patients, which was clinically significant for facilitating the work-up and prognosis improvement of PAH patients.