Purpose
•Pulmonary hypertension (PH) is associated with right ventricular (RV) pressure overload.
•RV overload leads to increased RV dimension, interventricular septum bulging and decreased left ventricular (LV) dimension.
•Cardiac magnetic resonance imaging (CMR) is increasingly used to evaluate RV and LV dimensions and function.
•The objective of our study was to document the effects of PH on RV and LV dimension
Methods and Materials
•Prospective study from June 2009 to September 2010.
•75 patients investigated for the first time in our PH referral centre for possible pulmonary vascular disease.
•CMR (1.5T) and right heart catheterization (±24 h delay) were performed in all patients.
•The radiologist analyzing the CMRs was blind to the results of the right heart catheterization.
•The four-chamber view was used for the determination of right ventricular end-diastolic area (RVEDA) and left ventricular end-diastolic area (LVEDA). Fig 1,
2.
•RV end-diastolic volume was calculated by using contiguous...
Results
n =75
Age,
yrs
60 ± 13
Gender
33F / 42M
BSA,
m2
1.8 ± 0.2
NYHA
6 II,
61 III,
9 IV
6MWD,
m
366 ± 125
SVO2,
%
61,5 ± 9,6
Diagnosis
19 PAH
7 associated to lung
disease
41 CTEPH
8 multifactorial
Table 1.
Clinical characteristics. BSA: body surface area,
NYHA: New York heart association functional class,
6MWD: six minute walking distance,
SVO2: mixed venous saturation,
CTEPH: chronic thromboembolic pulmonary hypertension,
PAH: pulmonary arterial hypertension.
Means ±SD.
n =75
RAP,
mmHg
7...
Conclusion
•Pulmonary artery resistance and mean pulmonary artery pressure were related to LV end-diastolic dimension,
not to RV end-diastolic dimension or volume.
•This may be explained by the impact of RV overload on interventricular septum (IVS) that leads to bulging of the IVS (thus decreasing LV area) and by the greater accuracy of LV analysis due to lesser anatomical complexity.
•Decreased LV dimension closely reflects RV overload in PH through right-to-left ventricular interdependence.
References
1- Galiè N,
Hoeper MM,
Humbert M,
Torbicki A,
Vachiery JL,
Barbera JA,
et al.
Guidelines for the diagnosis and treatment of pulmonary hypertension.
Task Force for Diagnosis and Treatment of Pulmonary Hypertension of European Society of Cardiology (ESC); European Respiratory Society (ERS); International Society of Heart and Lung Transplantation (ISHLT).
Eur Respir J 2009; 34: 1219-63.
2- McLaughlin VV,
Archer SL,
Badesch DB,
Barst RJ,
Farber HW,
Lindner JR,
et al.
ACCF/AHA 2009 expert consensus document on pulmonary hypertension a report of the American...
