Purpose
The compliance of the pulmonary artery is a key component in decoupling the right ventricle from the pulmonary bed,
allowing the right ventricle to work at maximum efficiency and protecting the microcirculation from large pressure gradients.[1–3] Indeed the stiffness of the pulmonary artery is a strong determinant of right ventricular function,[4] and increased stiffness causes distal pulmonary arterial endothelial dysfunction and inflammation.[5,6] Increased stiffness is independently associated with reduced functional capacity,[7] and higher mortality than the pulmonary artery pressures or pulmonary vascular resistance.[8–12] While stiffness...
Methods and Materials
Two separate study populations were recruited:
Young healthy volunteers (YHV): Ten healthy volunteers under 40 (3 Males,
7 females,
Mean age 31.5 ± 2.4 years) with no history of cardiovascular or lung disease were recruited to the study.
All individuals underwent high temporal resolution phase contrast scans of their main pulmonary artery and branch pulmonary arteries at baseline,
during exercise,
and at 6 months follow-up.
Older healthy volunteers (OHV): 20 healthy volunteers over the age of 55 (9 male,
11 female,
mean age 60.2 ±...
Results
PWV measurements
Using the TT technique PWV was measurable in all individuals,
however in 5 individuals,
one of the sides produced grossly inaccurate results (PWV excessively high or negative),
this error was slightly more common on the left (n=3) than the right (n=2). Using the high temporal resolution QA technique,
PWV was measurable in 29/30 of the study participants at the MPA,
29/30 at the RPA,
and 29/30 at the LPA.
Using the high spatial resolution QA technique,
PWV was measurable in 29/30 participants.
Using...
Conclusion
We have shown that: (i) The QA method using a high temporal resolution sequence through the right pulmonary artery using a calculation that accounts for wave reflections yields consistently better within scan,
inter-scan,
intra-observer and inter-observer reproducibility; (ii) Age related arterial stiffening as seen in the systemic circulation does not occur in the pulmonary vessels; (iii) Pulmonary PWV is stable and consistent at both rest and exercise.
This is the most comprehensive analysis of the techniques for measuring pulmonary PWV to date. Prior studies have...
References
1 Safar ME,
Levy BI,
Struijker-Boudier H.
Current perspectives on arterial stiffness and pulse pressure in hypertension and cardiovascular diseases.
Circulation 2003;107:2864–9.
doi:10.1161/01.CIR.0000069826.36125.B4
2 Fourie PR,
Coetzee AR,
Bolliger CT.
Pulmonary artery compliance: its role in right ventricular-arterial coupling.
Cardiovasc Res 1992;26:839–44.http://www.ncbi.nlm.nih.gov/pubmed/1451160 (accessed 3 Jan2014).
3 Weir-McCall JR,
Struthers AD,
Lipworth BJ,
et al.
The role of pulmonary arterial stiffness in COPD.
Respir Med 2015;109:1381–90.
doi:10.1016/j.rmed.2015.06.005
4 Gorgulu S,
Eren M,
Uslu N,
et al.
The determinants of right ventricular function in patients with atrial...