- Oral presentation
- Open Access
Myocardial scar in pulmonary hypertension: relationship to pulmonary hemodynamics, right ventricular function and remodeling
© Shehata et al; licensee BioMed Central Ltd. 2010
- Published: 21 January 2010
- Pulmonary Hypertension
- Right Ventricular
- Cardiac Magnetic Resonance
- Right Ventricular Function
- Right Ventricular Ejection Fraction
Right ventricular (RV) functional and structural monitoring is important as a prognostic measure in pulmonary hypertension (PH) patients. Cardiac magnetic resonance (CMR) imaging is the standard of reference for RV anatomical and functional assessment. Using delayed enhancement (DE)-CMR, presence of myocardial scar in association with PH was typically described at the RV septal insertions. However, its etiology in relation to RV remodeling, altered regional mechanics and pulmonary hemodynamics has not been fully assessed.
To identify predictors of scar burden at the RV septal insertions in PH patients.
We prospectively evaluated 38 patients with suspected PH with right heart catheterization (RHC) and CMR. 10 age-matched controls were included for CMR study comparison. Septal DE mass was quantified at the RV insertions. Systolic septal eccentricity index (EI), global RV function and remodeling indices were quantified using cine short axis images. Regional peak systolic circumferential (ECC) and longitudinal (ELL) strain were measured at the DE-corresponding sites using conventional tagged and Fast strain encoding acquisitions respectively.
In PH, total scar burden at the RV septal insertions is predicted by measures of RV remodeling in response to increased RV after-load. Local scar mass at the ASI is associated with reduced regional longitudinal contractility at the base of the left ventricle.
This article is published under license to BioMed Central Ltd.