Cardiac Magnetic Resonance Imaging in Pulmonary Arterial Hypertension: Ready for Clinical Practice and Guidelines?

Figures

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  Fig. 1. Cardiovascular magnetic resonance (CMR) images in a patient with idiopathic pulmonary arterial hypertension. (A) Cine image of 4-chamber view in end diastole showing an enlarged right ventricle (RV) and atrium (RA) and a small left ventricle (LV) and atrium (LA). The RV is hypertrophied, and pericardial effusion is present. (B) Cine short axis stack covering the heart from apex to the base is used for the volumetric assessment of ventricle (C) and atria (D). (C) Example of epicardial and endocardial delineations of both ventricles (in white) and (D) endocardial delineations of both atria. (E) RV and LV tracking for strain analysis in 4-chamber view. (F) Time resolved strain analysis curves for RV and LV (here global longitudinal strain (GLS)). (G) Atrio-ventricular plane in end diastole (red line) in 4-chamber view and (H) in end systole (blue line). Atrio-ventricular displacement (AVPD) is measured as the distance moving from base to apex between the red line in end diastole and the blue line in end systole. The longitudinal contribution to stroke volume (SV) is the volume encompassed by the atrio-ventricular plane marked with blue colour in the left ventricle and green colour…