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Right ventricular-vascular coupling ratio in pediatric pulmonary arterial hypertension: A comparison between cardiac magnetic resonance and right heart catheterization measurements
| Content Provider | Scilit |
|---|---|
| Author | Breeman, K. T. N. Dufva, M. Ploegstra, M. J. Kheyfets, V. Willems, T. P. Wigger, J. Hunter, K. S. Ivy, D. D. Berger, R. M. F. Truong, U. |
| Copyright Year | 2019 |
| Description | Journal: International Journal of Cardiology Background In pulmonary arterial hypertension (PAH), right ventricular (RV) failure is the main cause of mortality. Non-invasive estimation of ventricular-vascular coupling ratio (VVCR), describing contractile response to afterload, could be a valuable tool for monitoring clinical course in children with PAH. This study aimed to test two hypotheses: VVCR by cardiac magnetic resonance $(VVCR_{CMR}$) correlates with conventional VVCR by right heart catheterization $(VVCR_{RHC}$) and both correlate with disease severity. Methods and results Twenty-seven patients diagnosed with idiopathic and associated PAH without post-tricuspid shunt, who underwent RHC and CMR within 17 days at two specialized centers for pediatric PAH were retrospectively studied. Clinical functional status and hemodynamic data were collected. Median age at time of MRI was 14.3 years (IQR: 11.1–16.8), median PVRi 7.6 WU × $m^{2}$ (IQR: 4.1–12.2), median mPAP 40 mm Hg (IQR: 28–55) and median WHO-FC 2 (IQR: 2–3). $VVCR_{CMR,}$ defined as stroke volume/end-systolic volume ratio was compared to $VVCR_{RHC}$ by single-beat pressure method using correlation and Bland-Altman plots. $VVCR_{CMR}$ and $VVCR_{RHC}$ showed a strong correlation (r = 0.83, p < 0.001). $VVCR_{CMR}$ and $VVCR_{RHC}$ both correlated with clinical measures of disease severity (pulmonary vascular resistance index [PVRi], mean pulmonary artery pressure [mPAP], mean right atrial pressure [mRAP], and World Health Organization functional class [WHO-FC]; all p ≤ 0.02). Conclusions Non-invasively measured $VVCR_{CMR}$ is feasible in pediatric PAH and comparable to invasively assessed $VVCR_{RHC}$. Both correlate with functional and hemodynamic measures of disease severity. The role of VVCR assessed by CMR and RHC in clinical decision-making and follow-up in pediatric PAH warrants further clinical investigation. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6710117/pdf |
| Ending Page | 217 |
| Page Count | 7 |
| Starting Page | 211 |
| ISSN | 01675273 |
| e-ISSN | 18741754 |
| DOI | 10.1016/j.ijcard.2019.05.021 |
| Journal | International Journal of Cardiology |
| Volume Number | 293 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2019-10-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: International Journal of Cardiology Cardiology and Cardiovascular Diseases Cardiac Magnetic Resonance Pediatric Pulmonary Hypertension Right Heart Catheterization Right Ventricular Function Ventricular-vascular Coupling Ratio |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cardiology and Cardiovascular Medicine |
