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Biventricular Dysfunction and Ventricular Interdependence in Patients With Pulmonary Hypertension: A 3.0-T Cardiac MRI Feature Tracking Study.
- Source :
-
Journal of magnetic resonance imaging : JMRI [J Magn Reson Imaging] 2024 Jul; Vol. 60 (1), pp. 350-362. Date of Electronic Publication: 2023 Oct 21. - Publication Year :
- 2024
-
Abstract
- Background: Pulmonary hypertension (PH) results in right ventricular (RV) dysfunction, subsequently leading to left ventricular (LV) impairment. The mechanism underlying ventricular interdependence is largely uninvestigated.<br />Purpose: To explore the biventricular dysfunction and the ventricular interdependence in PH patients.<br />Study Type: Retrospective.<br />Population: One hundred and seven PH patients (mean pulmonary artery pressure >20 mmHg) and 72 age- and sex-matched controls with cardiac magnetic resonance imaging (MRI) studies.<br />Field Strength/sequence: 3.0 T/balanced steady-state free precession sequence.<br />Assessment: LV and RV ejection fractions (EF) and RV and LV radial, circumferential, and longitudinal strains were assessed using commercial software. Strains were compared between controls, PH patients with preserved RVEF (RVEF ≥40%, N = 48), and PH patients with reduced RVEF (RVEF <40%, N = 59).<br />Statistical Tests: Chi-squared tests or Fisher's exact test, t tests or Mann-Whitney U test, one-way ANOVA with Bonferroni's post hoc correction or Kruskal-Wallis test, Pearson or Spearman correlation, and multivariable linear regression analysis. A two-tailed P < 0.05 was deemed statistically significant.<br />Results: RV strain decreased sequentially from controls, through PH with preserved RVEF, to PH with reduced RVEF. PH patients with reduced RVEF had significantly lower LV strain, especially septal strain, and LV peak diastolic strain rate compared with both controls and PH patients with preserved RVEF. Multivariable analyses showed that RVEF was independently correlated with LV strain; furthermore, independent of RVEF, RV strain was significantly correlated with LV strain (LVGRS: β = 0.416; LVGCS: β = -0.371; LVGLS: β = 0.283).<br />Data Conclusion: Subclinical impairment of RV function was found in PH with preserved RVEF. LV strain was impaired when RV was dysfunctional, which was associated with worsening RV strain. Therefore, while focusing on improving RV function, LV dysfunction in PH patients should also be monitored and treated early in order to slow the progression of the disease.<br />Level of Evidence: 3 TECHNICAL EFFICACY: Stage 3.<br /> (© 2023 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.)
- Subjects :
- Humans
Female
Male
Retrospective Studies
Middle Aged
Aged
Adult
Stroke Volume
Magnetic Resonance Imaging, Cine methods
Hypertension, Pulmonary diagnostic imaging
Hypertension, Pulmonary physiopathology
Hypertension, Pulmonary complications
Ventricular Dysfunction, Right diagnostic imaging
Ventricular Dysfunction, Right physiopathology
Ventricular Dysfunction, Left diagnostic imaging
Ventricular Dysfunction, Left physiopathology
Heart Ventricles diagnostic imaging
Heart Ventricles physiopathology
Magnetic Resonance Imaging methods
Subjects
Details
- Language :
- English
- ISSN :
- 1522-2586
- Volume :
- 60
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of magnetic resonance imaging : JMRI
- Publication Type :
- Academic Journal
- Accession number :
- 37864419
- Full Text :
- https://doi.org/10.1002/jmri.29044