What does this research mean for the field?

Pulmonary arterial stiffness assessed by CMR-derived pulse wave velocity is significantly higher in combined pulmonary hypertension compared to precapillary pulmonary hypertension. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to evaluate pulmonary arterial stiffness (PAS) using cardiac MRI and to understand its relationship with invasive hemodynamic parameters in pulmonary hypertension.

January 10, 2026The International Journal of Cardiovascular Imaging0 citations

Relationship of cardiac MRI-derived pulmonary arterial stiffness markers and invasive hemodynamic

İBİpek BüberPamukkale University PHPaul M. HeerdtYale University ISInderjit SinghYale University

Key Result

Pulmonary arterial stiffness assessed by CMR-derived pulse wave velocity was 4.49 ± 1.32 m/s in combined PH, significantly higher than 3.40 ± 0.98 m/s in precapPH (p=0.04).

Key Points

The aim is to evaluate pulmonary arterial stiffness (PAS) using cardiac MRI and to understand its relationship with invasive hemodynamic parameters in pulmonary hypertension.
Retrospective analysis of 44 PH patients undergoing both RHC and CMR.
Patients classified into subgroups: precapillary, post-capillary, and combined PH.
PAS assessed using CMR-derived pulse wave velocity (PWV) and relative area change (RAC).
Compared PAS markers with invasive hemodynamic measurements from right heart catheterization.
PWV significantly higher in combined PH group compared to precapillary group.
RAC significantly lower in combined PH group than in post-capillary and precapillary groups.
PWV correlated positively with mean pulmonary artery pressure (mPAP), right atrial pressure (RAP), and right ventricular end-diastolic volume index (RVEDVi).
RAC showed a negative correlation with pulmonary vascular resistance (PVR).

Structured PICO

Do CMR-derived pulmonary arterial stiffness markers correlate with invasive hemodynamic parameters in patients with pulmonary hypertension?

Population

44 patients with pulmonary hypertension (PH) who underwent both right heart catheterization (RHC) and cardiac magnetic resonance (CMR), classified into pre-capillary (precapPH), post-capillary (postcapPH), and combined pre- and post-capillary (combPH) PH groups.

Intervention

Cardiac magnetic resonance (CMR) imaging to assess pulmonary arterial stiffness (PAS) via pulse wave velocity (PWV) and relative area change (RAC) of the main pulmonary artery.

Comparator

Right heart catheterization (RHC) invasive hemodynamic measurements (mPAP, PVR, right ventricular pressures, mixed venous saturation).

Outcome

Relationship between CMR-derived pulmonary arterial stiffness markers and invasive hemodynamic parameters from RHC across PH subgroups.surrogate

CMR-derived pulmonary arterial stiffness indices (PWV and RAC) correlate with invasive hemodynamic markers and may serve as useful noninvasive tools for assessing pulmonary vascular burden and differentiating disease severity in pulmonary hypertension.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Pulmonary arterial stiffness (PAS) is a noninvasive imaging biomarker associated with disease severity in pulmonary hypertension (PH). This study aimed to evaluate PAS using cardiac magnetic resonance (CMR) imaging and investigate its relationship with hemodynamic parameters from right heart catheterization (RHC) across PH subgroups. In this retrospective study, 44 patients with PH who underwent both RHC and CMR were classified into pre-capillary (precapPH), post-capillary (postcapPH), and combined pre- and post-capillary (combPH) PH groups based on guideline-defined criteria. PAS was assessed by CMR-derived pulse wave velocity (PWV) and relative area change (RAC) of the main pulmonary artery. RHC measurements included mPAP, PVR, and right ventricular pressures and mixed venous saturation. PWV was significantly higher in combPH (4.49 ± 1.32 m/s) compared to precapPH (3.40 ± 0.98 m/s, p = 0.04). RAC was significantly lower in combPH (0.18 ± 0.11) than in postcapPH (0.28 ± 0.09), p = 0.01) and precapPH (0.18 ± 0.07, p = 0.01). PWV correlated with mPAP (r = 0.34, p = 0.022), RAP (r = 0.39, p = 0.008), and RVEDVi (r = 0.34, p = 0.022), while RAC showed a negative correlation with PVR (r = - 0.36, p = 0.01). Distinct RV adaptation patterns were observed among subgroups, with combPH patients exhibiting the most impaired hemodynamics. CMR-derived PAS indices correlate with invasive hemodynamic markers and differ among PH subtypes. PWV and RAC may serve as useful noninvasive markers for assessing pulmonary vascular burden and differentiating disease severity in PH. Larger prospective studies are needed to validate their clinical utility.

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