Noninvasive monitoring of serial changes in pulmonary vascular resistance and acute vasodilator testing using cardiac magnetic resonance

García Álvarez, Ana and Fernández Friera, Leticia and García Ruiz, José Manuel and Nuño Ayala, Mario and Pereda, Daniel and Fernández Jiménez, Rodigo and Guzmán, Gabriela and Sánchez Quintana, Damian and Alberich Bayarri, Ángel and Pastor Escuredo, David and Sanz Rosa, David and García Prieto, Jaime and González Mirelis, Jesús G. and Pizarro, Gonzalo and Jiménez Borreguero, Luis Jesús and Fuster, Valentín and Sanz, Javier and Ibañez, Borja (2013). Noninvasive monitoring of serial changes in pulmonary vascular resistance and acute vasodilator testing using cardiac magnetic resonance. "Journal of the American College of Cardiology", v. 62 (n. 17); pp. 1621-1631. ISSN 0735-1097. https://doi.org/10.1016/j.jacc.2013.07.037.

Description

Title: Noninvasive monitoring of serial changes in pulmonary vascular resistance and acute vasodilator testing using cardiac magnetic resonance
Author/s:
  • García Álvarez, Ana
  • Fernández Friera, Leticia
  • García Ruiz, José Manuel
  • Nuño Ayala, Mario
  • Pereda, Daniel
  • Fernández Jiménez, Rodigo
  • Guzmán, Gabriela
  • Sánchez Quintana, Damian
  • Alberich Bayarri, Ángel
  • Pastor Escuredo, David
  • Sanz Rosa, David
  • García Prieto, Jaime
  • González Mirelis, Jesús G.
  • Pizarro, Gonzalo
  • Jiménez Borreguero, Luis Jesús
  • Fuster, Valentín
  • Sanz, Javier
  • Ibañez, Borja
Item Type: Article
Título de Revista/Publicación: Journal of the American College of Cardiology
Date: October 2013
Volume: 62
Subjects:
Freetext Keywords: Magnetic resonance; monitoring; pulmonary hypertension; pulmonary vascular resistance; vasodilator testing
Faculty: E.T.S.I. Telecomunicación (UPM)
Department: Ingeniería Electrónica
Creative Commons Licenses: Recognition - No derivative works - Non commercial

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Abstract

Objectives The study sought to evaluate the ability of cardiac magnetic resonance (CMR) to monitor acute and long-term changes in pulmonary vascular resistance (PVR) noninvasively. Background PVR monitoring during the follow-up of patients with pulmonary hypertension (PH) and the response to vasodilator testing require invasive right heart catheterization. Methods An experimental study in pigs was designed to evaluate the ability of CMR to monitor: 1) an acute increase in PVR generated by acute pulmonary embolization (n = 10); 2) serial changes in PVR in chronic PH (n = 22); and 3) changes in PVR during vasodilator testing in chronic PH (n = 10). CMR studies were performed with simultaneous hemodynamic assessment using a CMR-compatible Swan-Ganz catheter. Average flow velocity in the main pulmonary artery (PA) was quantified with phase contrast imaging. Pearson correlation and mixed model analysis were used to correlate changes in PVR with changes in CMR-quantified PA velocity. Additionally, PVR was estimated from CMR data (PA velocity and right ventricular ejection fraction) using a formula previously validated. Results Changes in PA velocity strongly and inversely correlated with acute increases in PVR induced by pulmonary embolization (r = –0.92), serial PVR fluctuations in chronic PH (r = –0.89), and acute reductions during vasodilator testing (r = –0.89, p ≤ 0.01 for all). CMR-estimated PVR showed adequate agreement with invasive PVR (mean bias –1.1 Wood units,; 95% confidence interval: –5.9 to 3.7) and changes in both indices correlated strongly (r = 0.86, p < 0.01). Conclusions CMR allows for noninvasive monitoring of acute and chronic changes in PVR in PH. This capability may be valuable in the evaluation and follow-up of patients with PH.

More information

Item ID: 28898
DC Identifier: http://oa.upm.es/28898/
OAI Identifier: oai:oa.upm.es:28898
DOI: 10.1016/j.jacc.2013.07.037
Official URL: http://www.sciencedirect.com/science/article/pii/S0735109713029446
Deposited by: Memoria Investigacion
Deposited on: 06 Jul 2014 10:52
Last Modified: 01 Nov 2014 23:56
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