Cardiac magnetic resonance imaging-derived pulmonary artery distensibility index correlates with pulmonary artery stiffness and predicts functional capacity in patients with pulmonary arterial hypertension

Ki Woon Kang, Hyuk-Jae Chang, Youngjin Kim, Byoung Wook Choi, Hye Sun Lee, Woo In Yang, ChiYoung Shim, Jongwon Ha, Namsik Chung

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Abstract

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 (R 2=0.34, P<0.001) and directly correlated with PA capacitance (R 2=0.35, P<0.001), and the distance in the 6MWT (R 2=0.61, P<0.001). Furthermore, PA distensibility <20% predicted poor FC (<400 m 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.

Original languageEnglish
Pages (from-to)2244-2251
Number of pages8
JournalCirculation Journal
Volume75
Issue number9
DOIs
Publication statusPublished - 2011 Sep 1

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Pulmonary Hypertension
Pulmonary Artery
Magnetic Resonance Imaging
Cardiac Catheterization
Vascular Resistance
Vascular Stiffness
Hemodynamics
Exercise
Lung

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{3ba5b706931c4b85bd03d7c457e3d708,
title = "Cardiac magnetic resonance imaging-derived pulmonary artery distensibility index correlates with pulmonary artery stiffness and predicts functional capacity in patients with pulmonary arterial hypertension",
abstract = "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 (R 2=0.34, P<0.001) and directly correlated with PA capacitance (R 2=0.35, P<0.001), and the distance in the 6MWT (R 2=0.61, P<0.001). Furthermore, PA distensibility <20{\%} predicted poor FC (<400 m 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.",
author = "Kang, {Ki Woon} and Hyuk-Jae Chang and Youngjin Kim and Choi, {Byoung Wook} and Lee, {Hye Sun} and Yang, {Woo In} and ChiYoung Shim and Jongwon Ha and Namsik Chung",
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Cardiac magnetic resonance imaging-derived pulmonary artery distensibility index correlates with pulmonary artery stiffness and predicts functional capacity in patients with pulmonary arterial hypertension. / Kang, Ki Woon; Chang, Hyuk-Jae; Kim, Youngjin; Choi, Byoung Wook; Lee, Hye Sun; Yang, Woo In; Shim, ChiYoung; Ha, Jongwon; Chung, Namsik.

In: Circulation Journal, Vol. 75, No. 9, 01.09.2011, p. 2244-2251.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cardiac magnetic resonance imaging-derived pulmonary artery distensibility index correlates with pulmonary artery stiffness and predicts functional capacity in patients with pulmonary arterial hypertension

AU - Kang, Ki Woon

AU - Chang, Hyuk-Jae

AU - Kim, Youngjin

AU - Choi, Byoung Wook

AU - Lee, Hye Sun

AU - Yang, Woo In

AU - Shim, ChiYoung

AU - Ha, Jongwon

AU - Chung, Namsik

PY - 2011/9/1

Y1 - 2011/9/1

N2 - 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 (R 2=0.34, P<0.001) and directly correlated with PA capacitance (R 2=0.35, P<0.001), and the distance in the 6MWT (R 2=0.61, P<0.001). Furthermore, PA distensibility <20% predicted poor FC (<400 m 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.

AB - 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 (R 2=0.34, P<0.001) and directly correlated with PA capacitance (R 2=0.35, P<0.001), and the distance in the 6MWT (R 2=0.61, P<0.001). Furthermore, PA distensibility <20% predicted poor FC (<400 m 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.

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