Rest and exercise-stress estimated pulmonary capillary wedge pressure using real-time free-breathing cardiovascular magnetic resonance imaging

Backhaus, Sören J.; Schulz, Alexander; Lange, Torben; Evertz, Ruben; Kowallick, Johannes T.; Hasenfuß, Gerd; Schuster, Andreas

doi:10.1016/j.jocmr.2024.101032

Cited by 3 publications

(1 citation statement)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although pulmonary capillary wedge pressure can also be estimated using routine CMR markers using left atrial volume and left ventricular mass, correlation with invasively derived filling pressures at right heart catheterisation appear to be moderate at best [13, 14]. Therefore, CMR-derived LWD appears to provide important information regarding pulmonary congestion, possibly related to left-sided ventricular filling pressures, beyond what can currently be determined with conventional CMR markers.…”

Section: Discussionmentioning

confidence: 99%

Lung water density is increased in patients at risk of heart failure and is largely independent of conventional CMR measures

Iyer,

Bryant,

et al. 2024

Preprint

View full text Add to dashboard Cite

AimsNon-invasive methods to quantify pulmonary congestion are lacking in clinical practice. Cardiovascular magnetic resonance (CMR) lung water density (LWD) mapping is accurate, reproducible, and has prognostic value. However, it is not known whether LWD is associated with routinely acquired CMR parameters.Methods and ResultsThis was a prospective, observational cohort including healthy controls and patients at risk of heart failure. Lung water density was measured using CMR with a free-breathing short echo time 3D cartesian gradient-echo sequence with a respiratory navigator at 1.5T. Associations were assessed between LWD, lung water volume (LWV) and cardiac volumes, left ventricular (LV) mass and function, myocardial native T1 and extracellular volume fraction (ECV). In patients at risk for heart failure (n=155), LWD was greater than in healthy controls (n=15) (30.4±5.0 vs 27.2±4.3%, p=0.02). Using receiver operating characteristic analysis, the optimal cut-off for LWD was 27.6% to detect at-risk patients (sensitivity 72%, specificity 73%, positive likelihood ratio 2.7, inverse negative likelihood ratio 2.6). LWD was univariably associated with body mass index (BMI), hypertension, right atrial (RA) area and LV mass (p<0.05 for all). In multivariable linear regression, only BMI remained associated with LWD (R2=0.32, p<0.001). In a separate multivariable analysis including only CMR markers, only RA area remained associated with LWD (R2=0.05, p=0.006).ConclusionLWD is increased in patients at risk for heart failure compared to controls, and is only weakly explained by conventional CMR measures. LWD provides diagnostic information which is largely independent of conventional CMR measures.

show abstract

Section: Discussionmentioning

confidence: 99%

Lung water density is increased in patients at risk of heart failure and is largely independent of conventional CMR measures

Iyer,

Bryant,

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Lung water density is increased in patients at risk of heart failure and is largely independent of conventional cardiovascular magnetic resonance measures

Iyer,

Bryant,

et al. 2024

European Heart Journal - Imaging Methods and Practice

View full text Add to dashboard Cite

Aims Non-invasive methods to quantify pulmonary congestion are lacking in clinical practice. Cardiovascular magnetic resonance (CMR) lung water density (LWD) mapping is accurate, reproducible, and has prognostic value. However, it is not known whether LWD is associated with routinely acquired CMR parameters. Methods and Results This was an observational cohort including healthy controls and patients at risk of heart failure. Lung water density was measured using CMR with a free-breathing short echo time 3D cartesian gradient-echo sequence with a respiratory navigator at 1.5T. Associations were assessed between LWD, lung water volume (LWV) and cardiac volumes, left ventricular (LV) mass and function, myocardial native T1 and extracellular volume fraction (ECV). In patients at risk for heart failure (n=155), LWD was greater than in healthy controls (n=15) (30.4±5.0 vs 27.2±4.3%, p=0.02). Using receiver operating characteristic analysis, the optimal cut-off for LWD was 27.6% to detect at-risk patients (sensitivity 72%, specificity 73%, positive likelihood ratio 2.7, inverse negative likelihood ratio 2.6). LWD was univariably associated with body mass index (BMI), hypertension, right atrial (RA) area and LV mass. In multivariable linear regression, only BMI remained associated with LWD (R2=0.32, p<0.001). Conclusion LWD is increased in patients at risk for heart failure compared to controls, and is only weakly explained by conventional CMR measures. LWD provides diagnostic information which is largely independent of conventional CMR measures.

show abstract

Sex-specific cardiac magnetic resonance pulmonary capillary wedge pressure

Garg,

Grafton-Clarke,

Matthews

et al. 2024

European Heart Journal Open

View full text Add to dashboard Cite

Aims Heart failure (HF) with preserved ejection fraction disproportionately affects women. There are no validated sex-specific tools for HF diagnosis despite widely reported differences in cardiac structure. This study investigates whether sex, as assigned at birth, influences cardiac magnetic resonance (CMR) assessment of left ventricular filling pressure (LVFP), a hallmark of HF agnostic to ejection fraction. Methods and results A derivation cohort of patients with suspected pulmonary hypertension and HF from the Sheffield centre underwent invasive right heart catheterization and CMR within 24 h of each other. A sex-specific CMR model to estimate LVFP, measured as pulmonary capillary wedge pressure (PCWP), was developed using multivariable regression. A validation cohort of patients with confirmed HF from the Leeds centre was used to evaluate for the primary endpoints of HF hospitalization and major adverse cardiovascular events (MACEs). Comparison between generic and sex-specific CMR-derived PCWP was undertaken. A total of 835 (60% female) and 454 (36% female) patients were recruited into the derivation and validation cohorts respectively. A sex-specific model incorporating left atrial volume and left ventricular mass was created. The generic CMR PCWP showed significant differences between males and females (14.7 ± 4 vs. 13 ± 3.0 mmHg, P > 0.001), not present with the sex-specific CMR PCWP (14.1 ± 3 vs. 13.8 mmHg, P = 0.3). The sex-specific, but not the generic, CMR PCWP was associated with HF hospitalization (hazard ratio 3.9, P = 0.0002) and MACE (hazard ratio 2.5, P = 0.001) over a mean follow-up period of 2.4 ± 1.2 years. Conclusion Accounting for sex improves precision and prognostic performance of CMR biomarkers for HF.

show abstract

Rest and exercise-stress estimated pulmonary capillary wedge pressure using real-time free-breathing cardiovascular magnetic resonance imaging

Cited by 3 publications

References 28 publications

Lung water density is increased in patients at risk of heart failure and is largely independent of conventional CMR measures

Lung water density is increased in patients at risk of heart failure and is largely independent of conventional CMR measures

Lung water density is increased in patients at risk of heart failure and is largely independent of conventional cardiovascular magnetic resonance measures

Sex-specific cardiac magnetic resonance pulmonary capillary wedge pressure

Contact Info

Product

Resources

About