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. 2020 May 2:10:26.
doi: 10.25259/JCIS_36_2020. eCollection 2020.

Quantification of Cardiac Output with Phase Contrast Magnetic Resonance Imaging in Patients with Pulmonary Hypertension

Jose Ricardo Po  1 , Matthew Tong  2 , Talha Meeran  3 , Alekhya Potluri  4 , Amresh Raina  5 , Mark Doyle  5 , Robert Biederman  5
Affiliations

Quantification of Cardiac Output with Phase Contrast Magnetic Resonance Imaging in Patients with Pulmonary Hypertension

Jose Ricardo Po et al. J Clin Imaging Sci. .

Abstract

Objective: The purpose of the study is to compare phase contrast (PC) imaging with invasive measurements of cardiac output (CO) in patients with pulmonary hypertension (PH).

Materials and methods: We analyzed 81 cases with PH who underwent cardiac magnetic resonance imaging and right heart catheterization (RHC). Measurement of CO and stroke volume (SV) by cardiac magnetic resonance (CMR) was performed by PC imaging of the proximal aorta (Ao) and pulmonary artery (Pa) and by RHC using the Fick and thermodilution (TD) methods.

Results: There was good correlation in CO measurements between PC and RHC; however, there was better correlation with SV measurements; Fick-TD (r=0.85), PC-TD (Ao r=0.77, Pa r=0.79), and PC-Fick (Ao r = 0.73, Pa r = 0.78). Bland-Altman analysis of SV showed that Pa PC had slightly lower standard deviation than Ao PC; PC-Fick (Pa SD = 15.11 vs. Ao SD = 16.4 ml) and PC-TD (Pa SD = 16.99 ml vs. Ao SD = 17.4 ml) while Fick-TD had the lowest (SD = 14.4 ml). Compared to Fick, measurement of SV with Ao PC (‒4.12 ml) and Pa PC (0.22 ml) both had lower mean difference than TD (‒11.1 ml).

Conclusion: Non-invasive measurement of CO and SV using PC-CMR correlates well with invasive measurement using RHC. Our study showed that PC-CMR had high accuracy and precision when compared to Fick. Among all the modalities, PC-CMR contributed the least amount of variation in measurements.

Keywords: Cardiac magnetic resonance imaging; Cardiac output; Phase contrast imaging; Pulmonary hypertension; Stroke volume.

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Conflict of interest statement

Robert Biederman, MD Honoraria: Amgen, Bracco, Lantheus, Sanofi/ RegeneronGrants: Biotronik, NIH/NHLB, United Therapeutics. Amresh Raina, MD Consultant: AbbotClinical trials: Actelion, Bayer, Bellerophon, United Therapeutics

Figures

Figure 1:
Figure 1:
Bland-Altman plot of difference in cardiac output; (a) Fick equation and thermodilution. (b) Aortic phase contrast imaging and Fick equation. (c) Aortic phase contrast imaging and thermodilution. (d) Pulmonary artery phase contrast imaging and Fick equation. (e) Pulmonary artery phase contrast imaging and thermodilution.
Figure 2:
Figure 2:
Bland-Altman plot of difference in mean stroke volume; (a) Fick equation and thermodilution. (b) Aortic phase contrast imaging and Fick equation. (c) Aortic phase contrast imaging and thermodilution. (d) Pulmonary artery phase contrast imaging and Fick equation. (e) Pulmonary artery phase contrast imaging and thermodilution.
See this image and copyright information in PMC

References

    1. van Wolferen SA, van de Veerdonk MC, Mauritz GJ, Jacobs W, Marcus JT, Marques KM, et al. Clinically significant change in stroke volume in pulmonary hypertension. Chest. 2011;139:1003–9. doi: 10.1378/chest.10-1066. - DOI - PubMed
    1. Brewis MJ, Bellofiore A, Vanderpool RR, Chesler NC, Johnson MK, Naeije R, et al. Imaging right ventricular function to predict outcome in pulmonary arterial hypertension. Int J Cardiol. 2016;218:206–11. doi: 10.1016/j.ijcard.2016.05.015. - DOI - PMC - PubMed
    1. Roeleveld RJ, Vonk-Noordegraaf A, Marcus JT, Bronzwaer JG, Marques KM, Postmus PE, et al. Effects of epoprostenol on right ventricular hypertrophy and dilatation in pulmonary hypertension. Chest. 2004;125:572–9. doi: 10.1378/chest.125.2.572. - DOI - PubMed
    1. Hoeper MM, Lee SH, Voswinckel R, Palazzini M, Jais X, Marinelli A, et al. Complications of right heart catheterization procedures in patients with pulmonary hypertension in experienced centers. J Am Coll Cardiol. 2006;48:2546–52. doi: 10.1016/j.jacc.2006.07.061. - DOI - PubMed
    1. Binanay C, Califf RM, Hasselblad V, O'Connor CM, Shah MR, Sopko G, et al. Evaluation study of congestive heart failure and pulmonary artery catheterization effectiveness: The ESCAPE trial. JAMA. 2005;294:1625–33. doi: 10.1001/jama.294.13.1625. - DOI - PubMed

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