Quantitative MRI comparison of pulmonary hemodynamics in mustard/senning-repaired patients suffering from transposition of the great arteries and healthy volunteers at rest

Abstract

In Mustard/Senning-repaired (MSR) patients, the right and left ventricles (RV, LV) act as the systemic and pulmonary ventricle, respectively. The purpose of the study was to compare non-invasively, at rest, pulmonary ventricle systolic function and hemodynamics in MSR patients with those of healthy volunteers. Velocity-encoded MR imaging was performed at the level of the main pulmonary artery (MPA) in ten male patients late after a Mustard/Senning correction performed early in infancy and in ten male volunteers. Both blood flow and MPA cross-sectional area variations were recorded over a complete cardiac cycle. MPA distensibility, body surface area (BSA)-normalized pulmonary ventricle systolic power and work were significantly lower in the MSR patients compared to volunteers. In particular, BSA-normalized LV systolic power and work in MSR patients were equal to 82 and 77% on average of those of the RV in volunteers (0.32 vs. 0.39 W/m2 and 0.10 vs. 0.13 J/m2), respectively. We conclude that in MSR patients at rest two unrelated findings were observed: (1) a reduced MPA distensibility and (2) a significantly lower systolic mechanical performance of the pulmonary LV compared to that of the RV in healthy volunteers. The latter quantification indirectly confirms the lowest systemic RV systolic mechanical performance previously published.

Pulmonary intravascular blood volume changes through the cardiac cycle in healthy volunteers studied by cardiovascular magnetic resonance measurements of arterial and venous flow

“…We found that the change in cross-sectional area of the pulmonary artery did not correlate with the pulmonary blood volume variation. Previous studies have used the change in cross sectional area of the pulmonary artery to assess the pulmonary vasculature in congenital heart disease [ 10 ]. Our findings indicate that the pulmonary blood volume variation is independent of this measure, and should thus not be seen as equivalent.…”

Pulmonary Blood Volume Variation Decreases after Myocardial Infarction in Pigs: A Quantitative and Noninvasive MR Imaging Measure of Heart Failure

“…The PBV variation was measured as the difference between the maximum and minimum of the cumulative volume variation ( Fig 5 ). Furthermore, previous studies have measured the change in cross-sectional area of the pulmonary artery as an approximate assessment of the change in volume of the entire pulmonary vasculature (pulmonary arteries and veins) ( 26 ). To illustrate how PBV variation relates to this measure, we measured the maximum variation in the cross-sectional area of the pulmonary trunk and compared it with the PBV variation.…”