Novel Method of Quantifying Pulmonary Vascular Resistance by Use of Simultaneous Invasive Pressure Monitoring and Phase-Contrast Magnetic Resonance Flow

Muthurangu, Vivek; Taylor, Andrew M.; Andriantsimiavona, Rado; Hegde, Sanjeet; Miquel, Marc E.; Tulloh, Robert; Baker, Edward J.; Hill, Derek L. G.; Razavi, Reza

doi:10.1161/01.cir.0000138741.72946.84

Cited by 146 publications

(118 citation statements)

References 14 publications

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“…Phase-contrast MR has been validated in small-diameter vessels and children. 17,28,29 We have demonstrated close agreement between RVSV and neoaortic FV in patients without valvar regurgitation. There was good agreement between the MR regurgitation fraction and the echocardiographic groupings.…”

Section: Valvar Regurgitationmentioning

confidence: 52%

Cardiac Magnetic Resonance Imaging After Stage I Norwood Operation for Hypoplastic Left Heart Syndrome

Muthurangu

Taylor²,

Hegde³

et al. 2005

Circulation

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Background-After the Norwood operation, a patient's suitability for proceeding to a bidirectional cavopulmonary connection (BCPC) is assessed by a combination of echocardiography and diagnostic cardiac catheterization. In this study, we describe the results of 37 patients who underwent cardiovascular magnetic resonance (MR) assessment before BCPC. Methods and Results-Cardiovascular MR and echocardiography were performed in 37 infants with hypoplastic left heart syndrome before BCPC, and the findings were compared with surgical findings. MR assessment of ventricular function and valvar regurgitation were compared with echocardiography. MR exhibited high sensitivity and specificity for identification of neoaortic (sensitivity 86%, specificity 97%) and left pulmonary artery (sensitivity 100%, specificity 94%) obstruction. Echocardiography exhibited poor sensitivity for identification of vascular stenosis. The mean right ventricular ejection fraction calculated from the MR data was 50Ϯ10%.

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Section: Valvar Regurgitationmentioning

confidence: 52%

Cardiac Magnetic Resonance Imaging After Stage I Norwood Operation for Hypoplastic Left Heart Syndrome

Muthurangu

Taylor²,

Hegde³

et al. 2005

Circulation

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“…In this technique, real-time CMR is performed with invasive catheters in situ, allowing simultaneous assessment of mPAP, PVRi, and septal curvature. 10,11 Thus, it represents the optimal setting for investigating the relationship between these metrics.…”

mentioning

confidence: 99%

Real-Time Magnetic Resonance Assessment of Septal Curvature Accurately Tracks Acute Hemodynamic Changes in Pediatric Pulmonary Hypertension

Pandya

Quail

Steeden

et al. 2014

Circ: Cardiovascular Imaging

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Background-This study assesses the relationship between septal curvature and mean pulmonary artery pressure and indexed pulmonary vascular resistance in children with pulmonary hypertension. We hypothesized that septal curvature could be used to estimate right ventricular afterload and track acute changes in pulmonary hemodynamics. Methods and Results-Fifty patients with a median age of 6.7 years (range, 0.45-16.5 years) underwent combined cardiac catheterization and cardiovascular magnetic resonance. The majority had idiopathic pulmonary arterial hypertension (n=30); the remaining patients had pulmonary hypertension associated with repaired congenital heart disease (n=17) or lung disease (n=3). Mean pulmonary artery pressure and pulmonary vascular resistance were acquired at baseline and during vasodilation. Septal curvature was measured using real-time cardiovascular magnetic resonance. There was a strong correlation between mean pulmonary artery pressure and SC min at baseline and during vasodilator testing (r=-0.81 and -0.85, respectively; P<0.01). A strong linear relationship also existed between pulmonary vascular resistance and minimum septal curvature indexed to cardiac output both at baseline and during vasodilator testing (r=-0.88 and -0.87, respectively; P<0.01). Change in septal curvature metrics moderately correlated with absolute change in mean pulmonary artery pressure and pulmonary vascular resistance, respectively (r=0.58 and -0.74; P<0.01). Septal curvature metrics were able to identify vasoresponders with a sensitivity of 83% (95% confidence interval, 0.36-0.99) and a specificity of 91% (95% confidence interval, 0.77-0.97), using the Sitbon criteria. Idiopathic pulmonary arterial hypertension subgroup analysis revealed 3 responders with ΔSC min values of 0.523, 0.551, and 0.568. If the middle value of 0.551 is taken as a cutoff, the approximate sensitivity would be 67% and the specificity would be 93%. Conclusions-Septal curvature metrics are able to estimate right ventricular afterload and track acute changes in pulmonary hemodynamics during vasodilator testing. This suggests that septal curvature could be used for continuing assessment of load in pulmonary hypertension. (Circ Cardiovasc Imaging. 2014;7:706-713.)

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“…(10) Added to this there is preliminary evidence to suggest that in certain situations combining phase-contrast MR and invasive pressure measurements is more accurate than traditional methods alone, which rely on the Fick principle. (59) Cardiovascular MR provides accurate 2D and 3D images of the defect.…”

Section: Ventricular Septal Defectmentioning

confidence: 99%

The Role of Cardiovascular Magnetic Resonance in Congenital Heart Disease

Puranik

Muthurangu

Taylor

2017

SAHJ

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Novel Method of Quantifying Pulmonary Vascular Resistance by Use of Simultaneous Invasive Pressure Monitoring and Phase-Contrast Magnetic Resonance Flow

Cited by 146 publications

References 14 publications

Cardiac Magnetic Resonance Imaging After Stage I Norwood Operation for Hypoplastic Left Heart Syndrome

Cardiac Magnetic Resonance Imaging After Stage I Norwood Operation for Hypoplastic Left Heart Syndrome

Real-Time Magnetic Resonance Assessment of Septal Curvature Accurately Tracks Acute Hemodynamic Changes in Pediatric Pulmonary Hypertension

The Role of Cardiovascular Magnetic Resonance in Congenital Heart Disease

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