Segmental Tissue Doppler Image-Derived Tei Index in Patients With Regional Wall Motion Abnormalities

Baek, Hee Kyung; Park, Tae-Ho; Park, Jong Seong; Seo, Jeongmin; Park, Sun-Yi; Kim, Byung Geun; Kim, Sang Ock; Soo, Kwang; Kim, Moo Hyun

doi:10.4070/kcj.2010.40.3.114

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…3,4 Dynamic contrast-enhanced (DCE) time-resolved magnetic resonance (MR) imaging is a technique whereby an intravenous contrast bolus can be tracked through the cardiopulmonary vascular system in three dimensions with time. [5][6][7][8][9][10][11][12] Several previous studies have assessed DCE-MR in patients with pulmonary hypertension, 8,9,[13][14][15] and sig-nificant correlations have been identified between timeresolved DCE-MR angiography and invasive prognostic indicators. However, the role of DCE-MR pulmonary vascular transit time (TT) measurements as prognostic markers in PAH has not yet been determined.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Contrast–Enhanced Magnetic Resonance Imaging in Patients with Pulmonary Arterial Hypertension

et al. 2014

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Dynamic contrast-enhanced (DCE) time-resolved magnetic resonance (MR) imaging is a technique whereby the passage of an intravenous contrast bolus can be tracked through the pulmonary vascular system. The aim of this study was to investigate the prognostic significance of DCE-MR pulmonary blood transit times in patients with pulmonary arterial hypertension (PAH). Seventy-nine patients diagnosed with PAH underwent pulmonary DCE imaging at 1.5 T using a time-resolved three-dimensional spoiled gradient echo sequence. The prognostic significance of two DCE parameters, full width at half maximum (FWHM) of the first-pass clearance curve and pulmonary transit time (PTT), along with demographic and invasive catheter measurements, was evaluated by univariate and bivariate Cox proportional hazards regression and Kaplan-Meier analysis. DCE-MR transit times were most closely correlated with cardiac index (CI) and pulmonary vascular resistance index (PVRI) and were both found to be accurate for detecting reduced CI (FWHM area under the curve [AUC] at receiver operating characteristic analysis = 0.91 and PTT AUC = 0.92, respectively) and for detecting elevated PVRI (FWHM AUC = 0.88 and PTT AUC = 0.84, respectively). During the follow-up period, 25 patients died. Patients with longer measurements of FWHM (P = 0.0014) and PTT (P = 0.004) were associated with poor outcome at Kaplan-Meier analysis, and both parameters were strong predictors of adverse outcome from Cox proportional hazards analysis (P = 0.013 and 0.010, respectively). At bivariate analysis, DCE measurements predicted mortality independent of age, gender, and World Health Organization functional class; however, invasive hemodynamic indexes CI, PVRI, and DCE measurements were not independent of one another. In conclusion, DCE-MR transit times predict mortality in patients with PAH and are closely associated with clinical gold standards CI and PVRI.

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