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Non‐invasive stroke volume measurement by cardiac magnetic resonance imaging and inert gas rebreathing in pulmonary hypertension
Author(s) -
McLure Lindsey E. R.,
Brown Aileen,
Lee Waiting N.,
Church Alistair C.,
Peacock Andrew J.,
Johnson Martin K.
Publication year - 2011
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/j.1475-097x.2010.01004.x
Subject(s) - medicine , magnetic resonance imaging , cardiology , pulmonary hypertension , stroke volume , stroke (engine) , cardiac magnetic resonance imaging , cardiac magnetic resonance , atrial fibrillation , radiology , ejection fraction , heart failure , mechanical engineering , engineering
Summary Objective: Right ventricular function determines the prognosis of pulmonary hypertension (PAH). Measurement of stroke volume (SV) non‐invasively could be a promising method to monitor disease progression. Cardiac magnetic resonance (CMR) imaging is recognized as an accurate and reproducible method to measure SV. Inert gas rebreathing (IGR) using acetylene is a validated but cumbersome method for pulmonary blood flow (PBF) measurement in PAH. A more convenient rebreathing technique using rapid photoacoustic analysis of nitrous oxide has been introduced and validated in left heart failure. We investigated the accuracy of CMR imaging and IGR using photoacoustic analysis to measure SV in patients under investigation for PAH. Methods: Thirty‐three patients (16♀:17♂) with suspected PAH following echocardiography had SV measured by CMR imaging (using pulmonary arterial{CMR PA} and aortic {CMR Ao} flow methods) and IGR. The results were compared with our reference standard: thermodilution (TD) measured during right heart catheterization (RHC). Results: All methods showed similar correlation for SV. Bland–Altman analysis con‐firmed acceptable levels of agreement between the four techniques. TD versus CMR Ao flow had bias (limits of agreement) of −5·41 ml (−22·37 to 11·56 ml), TD versus CMR PA flow 0·12 ml (−20·13 to 20·37 ml) and TD versus IGR 6·25ml (−16·01 to 28·51 ml). Conclusion: Cardiac magnetic resonance imaging and IGR using photoacoustic analysis in patients with suspected PAH provided non‐invasive measurements of SV that agreed closely with those obtained from TD measured during RHC.