Comparison of pulmonary circulation parameters acquired by cardiovascular magnetic resonance with right heart catheterization and transthoracic echocardiography in patients with recent-onset dilated cardiomyopathy

Abstract

Evaluating pulmonary circulation parameters (PCP) with cardiovascular magnetic resonance (CMR) is a relatively new approach with the potential for complex evaluation of the cardio-pulmonary system. Its impact might complement clinical assessment through right heart catheterization (RHC), the gold standard in evaluating pulmonary hypertension (PH) and hemodynamics, and transthoracic echocardiography (TTE). The study aims to examine the correlation of PCP with diastolic and systolic function and PH in patients with recent-onset dilated cardiomyopathy (RODCM). Eighty-four patients with recent-onset dilated cardiomyopathy (RODCM) were retrospectively included. All patients had a CMR examination, RHC (including pulmonary capillary wedge pressure (PCWP) and pulmonary vascular resistance (PVR)), and TTE. The pulmonary transit time (PTT), corrected pulmonary transit time (PTTc), systolic and diastolic function, and PH were assessed. Patients were divided into groups according to the PH and the diastolic function. PTT and PTTc correlated with PCWP, cardiac index, PVR, and E/e’. Patients with restrictive filling pattern showed significantly longer PTT. The receiver operating characteristic curve for PTT, PTTc, and PH was assessed with an area under the curve of 72.7% for PTT and 75.3% for PTTc, with cut-off values of 8.62 s (PTT) and 8.52 s (PTTc). To our knowledge, this is the first study focused on CMR-derived PCP in a RODCM group. Our findings show that PTT and PTTc are prolonged with impaired systolic and diastolic function, and with PH. Therefore, PCP might offer critical information to evaluate the cardio-pulmonary system comprehensively.