Prolonged central circulation transit time in patients with HFpEF and HFrEF by magnetic resonance imaging

Cao, Jie J; Li, Laura; McLaughlin, Jeannette; Passick, Michael

doi:10.1093/ehjci/jex051

Cited by 34 publications

(54 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sixthly, we did not obtain cardiac volumes during stress and could not assess changes in PBVI and cardiac output after adenosine administration. Furthermore, invasive haemodynamic measurements derived from right and/or left heart catheterization were not available in the current study, however it has been recently showed that PTT prolongation was significantly associated with haemodynamic abnormalities at invasive haemodynamic testing by right and left heart catheterization such as elevated pulmonary capillary wedge pressure, LV end-diastolic pressure, reduced cardiac index, and oxygen saturation, of which increased pulmonary capillary wedge pressure demonstrated the strongest association 10 . Finally, serum levels of natriuretic peptides, cardiopulmonary exercise testing data, and T1 mapping indices were not routinely available in our series.…”

Section: Discussionmentioning

confidence: 76%

“…Despite this, the identification of accurate and reproducible indices for quantitative assessment of haemodynamic congestion in HCM is still an unmet clinical need, in particular, to allow for early detection of disease progression and treatment guidance. An alternative approach to assess the presence and severity of diastolic dysfunction would be by measuring to what extent the elevated LV filling pressure is transmitted retrogradely into the pulmonary circulation leading to an increase in central transit time, 10 pulmonary blood volume, 11 and eventually to increased pulmonary capillary hydrostatic pressure (haemodynamic congestion). Pulmonary blood volume index (PBVI) by first-pass perfusion cardiovascular magnetic resonance (CMR) imaging has been shown to differentiate between stages of diastolic dysfunction in patients with HF and reduced LV ejection fraction and has been proposed as a quantitative marker of HF useful for quantification and monitoring of haemodynamic congestion 11 , 12 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary blood volume index as a quantitative biomarker of haemodynamic congestion in hypertrophic cardiomyopathy

Ricci

Aung

Thomson

et al. 2019

European Heart Journal - Cardiovascular Imaging

View full text Add to dashboard Cite

Aims The non-invasive assessment of left ventricular (LV) diastolic function and filling pressure in hypertrophic cardiomyopathy (HCM) is still an open issue. Pulmonary blood volume index (PBVI) by cardiovascular magnetic resonance (CMR) has been proposed as a quantitative biomarker of haemodynamic congestion. We aimed to assess the diagnostic accuracy of PBVI for left atrial pressure (LAP) estimation in patients with HCM. Methods and results We retrospectively identified 69 consecutive HCM outpatients (age 58 ± 11 years; 83% men) who underwent both transthoracic echocardiography (TTE) and CMR. Guideline-based detection of LV diastolic dysfunction was assessed by TTE, blinded to CMR results. PBVI was calculated as the product of right ventricular stroke volume index and the number of cardiac cycles for a bolus of gadolinium to pass through the pulmonary circulation as assessed by first-pass perfusion imaging. Compared to patients with normal LAP, patients with increased LAP showed significantly larger PBVI (463 ± 127 vs. 310 ± 86 mL/m2, P < 0.001). PBVI increased progressively with worsening New York Heart Association functional class and echocardiographic stages of diastolic dysfunction (P < 0.001 for both). At the best cut-off point of 413 mL/m2, PBVI yielded good diagnostic accuracy for the diagnosis of LV diastolic dysfunction with increased LAP [C-statistic = 0.83; 95% confidence interval (CI): 0.73–0.94]. At multivariable logistic regression analysis, PBVI was an independent predictor of increased LAP (odds ratio per 10% increase: 1.97, 95% CI: 1.06–3.68; P = 0.03). Conclusion PBVI is a promising CMR application for assessment of diastolic function and LAP in patients with HCM and may serve as a quantitative marker for detection, grading, and monitoring of haemodynamic congestion.

show abstract

Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Pulmonary blood volume index as a quantitative biomarker of haemodynamic congestion in hypertrophic cardiomyopathy

Ricci

Aung

Thomson

et al. 2019

European Heart Journal - Cardiovascular Imaging

View full text Add to dashboard Cite

show abstract

“…mechanism could be related to resistance to venous return to the left heart due to high atrial and ventricular filling pressures in the LVDD/ LVFP + group, allowing greater efficiency of oxygen uptake and carbon dioxide output [35,36]. Recently, pulmonary vasculature transit time was proven, by first pass perfusion imaging in non-COPD subjects, to be prolonged in HFpEF, and pulmonary artery oxygen saturation correlated negatively with central circulation transit time [37]. There are conflicting data about pulmonary transit time in COPD patients [38,39], but isolated diastolic dysfunction was shown to lead to prolonged transit time in non-COPD subjects [40,41] and prolonged transit time manipulation in heart failure with cardiac resynchronization therapy was highly associated with changes in V´E/V´CO 2 outcomes during exercise [42].…”

Section: Ventilatory Inefficiency and Gas-exchange Couplingmentioning

confidence: 99%

Left ventricular diastolic dysfunction and exertional ventilatory inefficiency in COPD

Müller

Utida

Augusto

et al. 2018

Respiratory Medicine

View full text Add to dashboard Cite

Background: Left ventricular diastolic dysfunction (LVDD) is highly prevalent in COPD and conflicting results have emerged regarding the consequences on exercise capacity in the 6MWT. We sought to examine the ventilatory efficiency and variability metrics as the primary endpoint and aerobic capacity (V'O 2) as the secondary endpoint. Methods: Forty subjects were included and submitted to comprehensive lung function tests, detailed pulsed-Doppler echocardiography, and cardiopulmonary exercise testing. Four subjects were excluded due to concomitant cardiac disease and two owing to COPD exacerbation. Results: Seventeen COPD/LVDD+ and seventeen COPD/LVDD-individuals were closely matched for baseline characteristics. Throughout the exercise, there was no difference between-groups for primary (V' E /V'CO 2 slope and V' E /V'CO 2 nadir, p > 0.05 for both) or secondary endpoints (V'O 2peak %pred, p > 0.05). Ventilatory variability remained unchanged. However, after very well age-and sex-matched subgroup analysis, five-moderate and three-mild COPD/LVDD + subjects with elevated left ventricular filling pressure (E/e' > 13, n = 8), presented a downward-shifted V' E /V'CO 2 slope (25.7 ± 5.1 vs 33.4 ± 7.1, p = 0.031) and V' E /V'CO 2 nadir reduction (29.7 ± 3.9 vs 36.3 ± 7.2, p = 0.042) besides significantly better V'O 2peak %pred (92.1 ± 21.6% vs 75.8 ± 13.1%, p = 0.045) compared to 8 COPD/LVDD-controls. Ventilatory variability remained once again unchanged. Conclusions: COPD/LVDD overlap is not associated with worse exercise tolerance and/or wasted ventilation in excess compared to controls, even when suspected for elevated left ventricular filling pressure. Further studies are warranted to study specifically if augmented pulmonary blood transit time can allow better gas-exchange, thus preserving exercise capacity under specific conditions in COPD patients without heart failure.

show abstract

“…The latter also represents a valuable parameter of pulmonary hemodynamics. Different clinical studies have demonstrated a prolonged PTT in association with increased pulmonary arterial pressure (PAP), increased pulmonary capillary wedge pressure (PCWP) and decreased left ventricular function in patients with pulmonary arterial hypertension 25 , heart failure 26 , 27 and congenital heart disease 28 .…”

Section: Discussionmentioning

confidence: 99%

Pulmonary blood volume estimation in mice by magnetic particle imaging and magnetic resonance imaging

Kaul¹,

Mummert²,

Graeser³

et al. 2021

Sci Rep

View full text Add to dashboard Cite

This methodical work describes the measurement and calculation of pulmonary blood volume in mice based on two imaging techniques namely by using magnetic particle imaging (MPI) and cardiac magnetic resonance imaging (MRI). Besides its feasibility aspects that may influence quantitative analysis are studied. Eight FVB mice underwent cardiac MRI to determine stroke volumes and anatomic MRI as morphological reference for functional MPI data. Arrival time analyses of boli of 1 µl of 1 M superparamagnetic tracer were performed by MPI. Pulmonary transit time of the bolus was determined by measurements in the right and left ventricles. Pulmonary blood volume was calculated out of stroke volume, pulmonary transit time and RR-interval length including a maximal error analysis. Cardiac stroke volume was 31.7 µl ± 2.3 µl with an ejection fraction of 71% ± 6%. A sharp contrast bolus profile was observed by MPI allowing subdividing the first pass into three distinct phases: tracer arrival in the right ventricle, pulmonary vasculature, and left ventricle. The bolus full width at half maximum was 578 ms ± 144 ms in the right ventricle and 1042 ms ± 150 ms in the left ventricle. Analysis of pulmonary transit time revealed 745 ms ± 81 ms. Mean RR-interval length was 133 ms ± 12 ms. Pulmonary blood volume resulted in 177 µl ± 27 µl with a mean maximal error limit of 27 µl. Non-invasive assessment of the pulmonary blood volume in mice was feasible. This technique can be of specific value for evaluation of pulmonary hemodynamics in mouse models of cardiac dysfunction or pulmonary disease. Pulmonary blood volume can complement cardiac functional parameters as a further hemodynamic parameter.

show abstract

Prolonged central circulation transit time in patients with HFpEF and HFrEF by magnetic resonance imaging

Abstract: Global and regional central TT can be assessed in the first pass perfusion imaging. Prolonged normalized global TT correlates with reduced EF in HFrEF and increased PCWP in HFpEF.

Cited by 34 publications

References 25 publications

Pulmonary blood volume index as a quantitative biomarker of haemodynamic congestion in hypertrophic cardiomyopathy

Pulmonary blood volume index as a quantitative biomarker of haemodynamic congestion in hypertrophic cardiomyopathy

Left ventricular diastolic dysfunction and exertional ventilatory inefficiency in COPD

Pulmonary blood volume estimation in mice by magnetic particle imaging and magnetic resonance imaging

Contact Info

Product

Resources

About