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Methods We evaluated 48 patients with suspected PH referred for CMR as part of their clinical assessment. Imaging was performed at 1.5T. Retrospectively gated cines of a left ventricular short axis stack were obtained using SSFP (TR 2.9 ms, TE 1.5 ms, flip angle 60°, temporal resolution ~40 ms). LGE images of the same views were obtained 10 minutes after infusion of Gd-DTPA (0.2 mmol/kg) using phase sensitive inversion recovery (TR 4.5 ms, TE 2.2 ms, TI 200-300 ms, flip angle 30°, PSIR flip angle 5°, voxel size 2 × 2 × 10 mm, sense 2). The cines were used to determine RV end-diastolic volume (RVEDV), end-systolic volume (RVESV), and ejection fraction (RVEF). Two readers blinded to hemodynamic, functional, and laboratory data jointly determined the presence of RVIP-LGE. A subgroup of these patients underwent right heart catheterization (n = 28) and exercise testing (n = 34). Continuous variables were reported as mean ± standard deviation. Groups (based on presence or absence of LGE) were compared using a t-test, with p-value < 0.05 being significant.

Pulmonary hypertension and late gadolinium enhancement of the right ventricular insertion point and its clinical implications