Source: Annual Congress 2011 - Physiology of human pulmonary hypertension
Disease area: Pulmonary vascular diseases

Abstract

Background and aim: Pulmonary arterial hypertension (PAH, group 1) and chronic thromboembolic PH (CTEPH, group 4) have different pathophysiology. Our study tested the hypothesis that PAH and CTEPH display different characteristics on cardiac magnetic resonance imaging (CMR).
Methods: 46 patients (mean age 54±15 yrs; 22F) entered the study, namely 23 PAH and 23 CTEPH matched for age and sex. They underwent right heart catheterization and cine and phase-contrast CMR (1.5 T scanner, Siemens) with electrocardiographic gating (delay ±48h).
Results: PAH and CTEPH had similar body surface area (1.7±0.2 vs 1.8±0.2 m²) and similar invasive hemodynamics, including mean pulmonary arterial pressure (48±14 vs 47±11 mmHg), pulmonary vascular resistance (9±4 vs 10±4 wu) and right atrial pressure (7±4 vs 7±5 mmHg) (each p = ns). PAH and CTEPH had similar ventricular morphology and function, especially RV ejection fraction (30±13 vs 30±15%), RV end-diastolic area (34±8 vs 32±9 cm²), left ventricular end-diastolic area (26±5 vs 26±7 cm²) and area ratio (1.3±0.3 vs 1.3±0.4) (each p = ns). Pulmonary artery data were similar, namely pulmonary artery trunk diameter (33±4 vs 33±4 mm), pulmonary artery pulsatility (15±8 vs 18±14%), mean pulmonary flow (4.5±1.8 vs 4.1±1.3 L/min), mean flow velocity (9±4 vs 9±3 cm/sec), acceleration time (94±15 vs 101±14 msec) and ejection time (317±34 vs 315±52 msec) (each p = ns).
Conclusion: Age- and sex-matched PAH and CTEPH patients displayed similar values of the classical CMR indices. Although these results need to be confirmed on larger samples, it is suggested that the main CMR data may be interpreted without the need to take into account the PAH vs CTEPH etiology.

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S. Hoette, N. Creuze, D. Musset, X. Jais, L. Savale, D. Natali, S. Gunther, O. Sitbon, G. Simonneau, M. Humbert, D. Chemla (Clamart, France). Comparing cardiac magnetic resonance imaging in group 1 and group 4 pulmonary hypertension. Eur Respir J 2011; 38: Suppl. 55, 2309

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