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Pulmonary hypertension and late gadolinium enhancement of the right ventricular insertion point and its clinical implications
© Freed et al; licensee BioMed Central Ltd. 2010
Published: 21 January 2010
We evaluated 48 patients with suspected PH referred for CMR as part of their clinical assessment. Imaging was performed at 1.5T. Retrospectively gated cines of a left ventricular short axis stack were obtained using SSFP (TR 2.9 ms, TE 1.5 ms, flip angle 60°, temporal resolution ~40 ms). LGE images of the same views were obtained 10 minutes after infusion of Gd-DTPA (0.2 mmol/kg) using phase sensitive inversion recovery (TR 4.5 ms, TE 2.2 ms, TI 200-300 ms, flip angle 30°, PSIR flip angle 5°, voxel size 2 × 2 × 10 mm, sense 2). The cines were used to determine RV end-diastolic volume (RVEDV), end-systolic volume (RVESV), and ejection fraction (RVEF). Two readers blinded to hemodynamic, functional, and laboratory data jointly determined the presence of RVIP-LGE. A subgroup of these patients underwent right heart catheterization (n = 28) and exercise testing (n = 34). Continuous variables were reported as mean ± standard deviation. Groups (based on presence or absence of LGE) were compared using a t-test, with p-value < 0.05 being significant.
RVIP-LGE was seen in 70% of patients with PH. In our cohort, the finding was associated with adverse right ventricular remodeling and function and worse pulmonary artery hemodynamics. Further study is required to determine prognostic implications as this cohort is followed over time.
This article is published under license to BioMed Central Ltd.