Four-Dimensional Magnetic Resonance Pulmonary Flow Imaging for Assessing Pulmonary Vasculopathy in Patients with Postcapillary Pulmonary Hypertension

被引：0

作者：

Nuche, Jorge ^{[1
,2
,3
]}

Ponz, Ines ^{[4
]}

Sanchez Sanchez, Violeta ^{[1
,2
,3
]}

Bobeda, Javier ^{[5
]}

Gaitan, Angel ^{[6
,7
]}

Lopez-Linares, Karen ^{[5
,7
]}

Garcia-Cosio, Maria Dolores ^{[1
,2
]}

Sarnago Cebada, Fernando ^{[1
]}

Gonzalez, Javier Sanchez ^{[3
,8
]}

Arribas Ynsaurriaga, Fernando ^{[1
,2
,9
]}

Ruiz-Cabello, Jesus ^{[9
,10
,11
,12
]}

Ibanez, Borja ^{[2
,3
,13
]}

Delgado, Juan F. ^{[1
,2
,7
]}

机构：

[1] Hosp Univ 12 Octubre, Inst Invest Sanitaria Hosp Octubre 12 Imas12, Cardiol Dept, Serv Cardiol, Ave Cordoba S-N, Madrid 28041, Spain

[2] Ctr Invest Biomed Red Enfermedades Cardiovasc CIB, Madrid 28029, Spain

[3] Ctr Nacl Invest Cardiovasc, Calle Melchor Fernandez Almagro 3, Madrid 28029, Spain

[4] Hosp Univ La Paz, Cardiol Dept, Inst Invest IDIPAZ, Paseo Castellana 261, Madrid 28029, Spain

[5] Basque Res & Technol Alliance BRTA, Vicomtech, Paseo Mikeletegi 57, Donostia San Sebastian 20009, Spain

[6] Hosp Univ 12 Octubre, Dept Cardiol, Inst Invest Sanitaria Hosp 12 Octubre Imasl2, Ave Cordoba S-N, Madrid 28041, Spain

[7] Biogipuzkoa Hlth Res Inst, eHlth Grp, Paseo Dr Beguiristan S-N, San Sebastian 20014, Spain

[8] Philips Healthcare Iberica, Calle Maria Portugal 1, Madrid 28050, Spain

[9] Univ Complutense Madrid, Plaza Ramon & Cajal S-N, Madrid 28040, Spain

[10] Basque Res & Technol Alliance BRTA, CIC BiomaGUNE, Bilbao 48009, Spain

[11] Basque Fdn Sci, Ikerbasque, Kurutz Gain Ind Dea, Bilbao 48009, Spain

[12] Ctr Invest Biomed Red Enfermedades Resp CIBERES, Calle Melchor Fernandez Almagro 3, Madrid 28029, Spain

[13] Fdn Jimenez Diaz, IIS, Ave Reyes Catolicos 2, Madrid 28040, Spain

来源：

JOURNAL OF CLINICAL MEDICINE | 2025年 / 14卷 / 03期

关键词：

heart failure; pulmonary hypertension; magnetic resonance; four-dimensional flow; HEART-FAILURE; EPIDEMIOLOGY;

D O I：

10.3390/jcm14030929

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Noninvasive techniques for diagnosing combined postcapillary pulmonary hypertension (CpcPH) are unavailable. Objective: To assess the diagnostic performance of cardiac magnetic resonance (CMR)-based four-dimensional (4D)-flow analysis in identifying CpcPH. Methods: Prospective observational study of heart failure (HF) patients with suspected pulmonary hypertension (PH) who underwent simultaneous CMR and right heart catheterization. The 4D-flow biomarkers were calculated using an automatic pipeline. A predictive model including 4D-flow biomarkers associated with CpcPH with a p-value < 0.20 was built to determine the diagnostic performance of 4D-flow analysis to identify CpcPH. Results: A total of 46 HF patients (55.4 +/- 14 years, 63% male) with confirmed PH (19 [41%] isolated postcapillary PH [IpcPH], 27 [59%] CpcPH) were included. No differences were found in baseline characteristics, echocardiography, or CMR anatomical and functional parameters, except for a higher Doppler-estimated systolic pulmonary pressure and larger pulmonary artery in CpcPH patients. The 4D-flow CMR analysis was performed in 31 patients (67%). The maximal peak velocity (67.1 [62.2-77.5] cm/s-IpcPH vs. 58.2 [45.8-66.0] cm/s-CpcPH; p = 0.021) and maximal helicity (339.9 [290.0-391.8]) cm/s(2)-IpcPH vs. 226.0 (173.5-343.7) cm/s(2)-CpcPH; p = 0.026) were significantly lower in patients with CpcPH. A maximal multivariable model including sex, maximal average, and peak velocities, Reynolds number, flow rate, and helicity showed fair diagnostic performance (area under the curve: 0.768 [95%-CI: 0.572-0.963]; sensitivity: 100%; specificity: 55%). Conclusions: In HF patients with PH, 4D-flow-derived maximal peak velocity and maximal helicity were significantly lower in CpcPH patients. A multiparametric model including maximal 4D-flow-derived biomarkers showed good diagnostic performance for identifying CpcPH.

引用

页数：17