Open AccessCMR‐based heart deformation analysis for quantification of hemodynamics and right ventricular dysfunction in patients with CTEPH
Author(s) -
Tao Xincao,
Liu Min,
Liu Weifang,
Xie Wanmu,
Wan Jun,
Zhai Zhenguo,
Wang Chen
Publication year - 2020
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.13128
Subject(s) - medicine , cardiology , ejection fraction , hemodynamics , pulmonary hypertension , natriuretic peptide , receiver operating characteristic , heart failure
Quantification of hemodynamics and right ventricular (RV) function is crucial for pulmonary hypertension (PH). Cardiovascular magnetic resonance–based heart deformation analysis (CMR‐HDA) has been used to assess the ventricular strain. Objective This study was to determine the correlation of right ventricular longitudinal strain (RVLS) assessed with CMR‐HDA with RV function as well as hemodynamics in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods Thirty‐six CTEPH patients were prospectively included in this research. Each patients underwent CMR and right heart catheterization (RHC). RVLS and RV ejection fraction (RVEF) was quantified from cine images acquired with a retrospectively gated turbo FLASH gradient‐echo sequence. The late gadolinium enhancement (LGE) images were acquired using a 2D inversion recovery phase‐sensitive fast gradient‐echo sequence. Hemodynamics were determined with RHC. Results Right ventricular longitudinal strain measured with CMR‐HDA was −13.99 ± 4.94%. Bland–Altman plots showed statistical agreement with RVLS with low intra‐ and interobserver variability. RVLS correlated with serum N‐terminal‐pro‐B‐type natriuretic peptide ( r = 0.615, P < .001). RVLS inversely correlated with RVEF ( r = −0.699, P < .001), and it was positively correlated with both RVESV ( r = 0.664, P < .001) and myocardial the volume of LGE ( r = 0.447, P = .008). Receiver‐operating characteristic (ROC) indicated that RVLS values of >−14.20% could be used to predict RVEF <40% with a 100% sensitivity and a 96.7% specificity. Hemodynamically, RVLS was positively correlated with mean pulmonary artery pressure ( r = 0.598, P < .001) and pulmonary vascular resistance ( r = 0.685, P < .001). Conclusion Right ventricular longitudinal strain assessed by CMR‐HDA is a readily available and reproducible parameters of RV function. RVLS >−14.20% suggests the presence of RV dysfunction.