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- Open Access
Pulmonary arterial hypertension is associated with increased T1 relaxation times and decreased left ventricular performance in spite of preserved left ventricular function
© Homsi et al. 2016
- Published: 27 January 2016
- Pulmonary Arterial Hypertension
- Cardiac Magnetic Resonance
- Pulmonary Arterial Hypertension Patient
- Left Ventricle Ejection Fraction
- Diffuse Fibrosis
Pulmonary arterial hypertension (PAH) mainly affects the right (RV). Due to ventricular interdependence, PAH may also affect the left ventricle (LV) leading to opposite adaptive changes with an LV-atrophy and diffuse fibrosis. Strain analysis detects ventricular dysfunction even in patients with preserved ventricular function. Cardiac magnetic resonance (CMR) mapping techniques with determination of T1 and T2 relaxation times (T1 resp T2) may allow for discrimination between healthy myocardium and diffuse fibrosis in PAH patients. This study was performed to evaluate the association between myocardial changes assessed by strain analysis, and by native T1 and T2 map in patients with PAH.
17 Patients with PAH (9 men, 8 women, mean age 64.2 ± 13.6years[y]) and 18 healthy volunteers (9 men, 9 women, mean age 59.7 ± 10.0) were examined on a 1.5 Tesla MR system (Ingenia, Philips). Native T1s were assessed using the modified Look-Locker inversion recovery sequence and T2s were assessed using a GraSE sequence. Hematocrit-corrected extracellular volume fraction values (ECV) were calculated from pre- and post-contrast T1 values. RV and LV longitudinal strain was assessed during postprocessing of standard SSFP cine images by CMR feature tracking using a dedicated software (Diogenes, TomTec, Unterschleissheim, Germany). LV and RV function were assessed by volumetric analysis.
LV ejection fraction did not differ between PAH patients and healthy volunteers (61.2 ± 6.9% vs. 62.3 ± 6.8%; P=0.64). Left ventricular T1 s and ECV were significantly higher in patients with PAH (1048.5.3 ± 46.6 ms vs. 965.2 ± 24.6 ms; p < 0.01 and 32.4 ± 5.7% vs. 28.6 ± 4.5%; P=0.04). LV longitudinal strain was significantly lower in patients with PAH (-18.0 ± 5.6 vs. -23.0 ± 8.8, p < 0.01). RV longitudinal strain and RV-Ejection fraction were both significantly lower in patients with PAH. There were no significant differences in T2 relaxation times, age, body mass index, or sex.
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