Perioperative CTEPH patient monitoring with 2D phase-contrast MRI reflects clinical, cardiac and pulmonary perfusion changes after pulmonary endarterectomy.
Christoph P CzernerChristian SchoenfeldSerghei CebotariJulius RenneTill F KaireitHinrich B WintherGesa H PöhlerKaren M OlssonMarius M HoeperFrank WackerJens Vogel-ClaussenPublished in: PloS one (2020)
Magnetic resonance imaging (MRI) is an emerging tool for diagnosis and treatment monitoring of chronic thromboembolic pulmonary hypertension (CTEPH). The current study aims to identify central pulmonary arterial hemodynamic parameters that reflect clinical, cardiac and pulmonary changes after PEA. 31 CTEPH patients, who underwent PEA and received pre- and postoperative MRI, were analyzed retrospectively. Central pulmonary arterial blood flow, lung perfusion and right heart function data were derived from MRI. Mean pulmonary arterial pressure (mPAP) and 5-month follow-up six-minute walk-distance (6MWD) were assessed. After PEA, mPAP decreased significantly and patients achieved a higher 6MWD. Central pulmonary arterial blood flow velocities, pulmonary blood flow (PBF) and right ventricular function increased significantly. Two-dimensional (2D) phase-contrast (PC) MRI-derived average mean velocity, maximum mean velocity and deceleration volume changes after PEA correlated with changes of 6MWD and right heart ejection fraction (RVEF). Deceleration volume is a novel 2D PC MRI parameter showing further correlation with PBF changes. In conclusion, 2D PC MRI-derived main pulmonary hemodynamic changes reflect changes of RVEF, PBF and 5-month follow-up 6MWD and may be used for future CTEPH patient monitoring after PEA.
Keyphrases
- pulmonary hypertension
- blood flow
- contrast enhanced
- magnetic resonance imaging
- ejection fraction
- pulmonary artery
- diffusion weighted imaging
- pulmonary arterial hypertension
- computed tomography
- magnetic resonance
- end stage renal disease
- heart failure
- chronic kidney disease
- newly diagnosed
- atrial fibrillation
- patients undergoing
- prognostic factors
- case report
- acute kidney injury
- coronary artery
- acute coronary syndrome
- big data
- current status
- percutaneous coronary intervention