CMRI-derived pulmonary artery distensibility <20% predicted poor functional capacity (<400m in 6-minute walk test) with 82% sensitivity and 94% specificity in patients with PAH.
Observational (n=35)
Does CMRI-derived pulmonary artery distensibility index correlate with invasive pulmonary artery stiffness and predict functional capacity in patients with pulmonary arterial hypertension?
Non-invasive CMRI-derived pulmonary artery distensibility correlates well with invasive hemodynamics and strongly predicts functional capacity in patients with pulmonary arterial hypertension.
Effect estimate: R²=0.61
p-value: p=<0.001
BACKGROUND: Increased stiffness of the pulmonary vascular bed is known to increase mortality in patients with pulmonary arterial hypertension (PAH); and pulmonary artery (PA) stiffness is also thought to be associated with exercise capacity. The purpose of the present study was to investigate whether cardiac magnetic resonance imaging (CMRI)-derived PA distensibility index correlates with PA stiffness estimated on right heart catheterization (RHC) and predicts functional capacity (FC) in patients with PAH. METHODS AND RESULTS: Thirty-five consecutive PAH patients (23% male, mean age, 44 ± 13 years; 69% idiopathic) underwent CMRI, RHC, and 6-min walk test (6MWT). PA distensibility indices were derived from cross-sectional area change (%) in the transverse view, perpendicular to the axis of the main PA, on CMRI (maximum area-minimum area)/minimum area during cardiac cycle. Among the PA stiffness indices, pulmonary vascular resistance (PVR) and PA capacitance were calculated using hemodynamic dataset from RHC. CMRI-derived PA distensibility was inversely correlated with PVR (R²=0.34, P<0.001) and directly correlated with PA capacitance (R²=0.35, P<0.001), and the distance in the 6MWT (R²=0.61, P<0.001). Furthermore, PA distensibility <20% predicted poor FC (<400m in 6MWT) with a sensitivity of 82% and a specificity of 94%. CONCLUSIONS: Non-invasive CMRI-derived PA distensibility index correlates with PA stiffness and can predict FC in patients with PAH.
Kang et al. (Sat,) conducted a observational in Pulmonary arterial hypertension (PAH) (n=35). Cardiac magnetic resonance imaging (CMRI)-derived PA distensibility index vs. Right heart catheterization (RHC) was evaluated on Correlation of PA distensibility with PVR, PA capacitance, and 6MWT distance (R²=0.61, p=<0.001). CMRI-derived pulmonary artery distensibility <20% predicted poor functional capacity (<400m in 6-minute walk test) with 82% sensitivity and 94% specificity in patients with PAH.