TY - JOUR
T1 - Reproducibility of peak filling and peak emptying rate determined by cardiovascular magnetic resonance imaging for assessment of biventricular systolic and diastolic dysfunction in patients with pulmonary arterial hypertension
AU - Göransson, Christoffer
AU - Vejlstrup, Niels
AU - Carlsen, Jørn
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Right ventricular (RV) and left ventricular (LV) diastolic stiffness may be independent contributors to disease progression in pulmonary arterial hypertension (PAH). The aims of this study are to assess reproducibility of peak emptying rate (PER) and early diastolic peak filling rate (PFR) for both the RV and the LV in PAH and study their relationship to stroke volume (SV). Triple weekly repetition of 20 (totalling 60) cardiovascular magnetic resonance (CMR) scans, were done on 10 patients with PAH and 10 healthy controls. RV and LV volumes were measured over the full cardiac cycle. PER and PFR were calculated as the first derivative of the time–volume relationship in both the RV and the LV and indexed to body surface area. Reproducibility and the relation to SV were studied in a mixed model. PFR was lower in PAH in both the RV (PAH = 170 mL/m2/s, controls = 236 mL/m2/s [p < 0.01]) and in the LV (PAH = 209 mL/m2/s, controls = 311 mL/m2/s [p < 0.01]). PERs were not significantly different between patients and controls. Reproducibility of PER and PFR was high. A trial targeting normalization of PFR requires a total sample size of < 20. PER and PFR in both ventricles were strongly associated with stroke volume (all four: p < 0.01). Biventricular diastolic dysfunctions are strongly associated with stroke volume, and CMR can quantify them with high reproducibility, enabling small sample sizes for trials of therapies targeting diastolic dysfunction to increase survival.
AB - Right ventricular (RV) and left ventricular (LV) diastolic stiffness may be independent contributors to disease progression in pulmonary arterial hypertension (PAH). The aims of this study are to assess reproducibility of peak emptying rate (PER) and early diastolic peak filling rate (PFR) for both the RV and the LV in PAH and study their relationship to stroke volume (SV). Triple weekly repetition of 20 (totalling 60) cardiovascular magnetic resonance (CMR) scans, were done on 10 patients with PAH and 10 healthy controls. RV and LV volumes were measured over the full cardiac cycle. PER and PFR were calculated as the first derivative of the time–volume relationship in both the RV and the LV and indexed to body surface area. Reproducibility and the relation to SV were studied in a mixed model. PFR was lower in PAH in both the RV (PAH = 170 mL/m2/s, controls = 236 mL/m2/s [p < 0.01]) and in the LV (PAH = 209 mL/m2/s, controls = 311 mL/m2/s [p < 0.01]). PERs were not significantly different between patients and controls. Reproducibility of PER and PFR was high. A trial targeting normalization of PFR requires a total sample size of < 20. PER and PFR in both ventricles were strongly associated with stroke volume (all four: p < 0.01). Biventricular diastolic dysfunctions are strongly associated with stroke volume, and CMR can quantify them with high reproducibility, enabling small sample sizes for trials of therapies targeting diastolic dysfunction to increase survival.
KW - Adult
KW - Arterial Pressure
KW - Case-Control Studies
KW - Diastole
KW - Female
KW - Humans
KW - Hypertension, Pulmonary/complications
KW - Magnetic Resonance Imaging, Cine
KW - Male
KW - Middle Aged
KW - Predictive Value of Tests
KW - Pulmonary Artery/physiopathology
KW - Reproducibility of Results
KW - Systole
KW - Ventricular Dysfunction, Left/diagnostic imaging
KW - Ventricular Dysfunction, Right/diagnostic imaging
KW - Ventricular Function, Left
KW - Ventricular Function, Right
U2 - 10.1007/s10554-017-1281-1
DO - 10.1007/s10554-017-1281-1
M3 - Journal article
C2 - 29168055
SN - 1569-5794
VL - 34
SP - 777
EP - 786
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
IS - 5
ER -