Diagnostic accuracy of cardiovascular magnetic resonance imaging of right ventricular morphology and function in the assessment of suspected pulmonary hypertension results from the ASPIRE registry

Journal of Cardiovascular Magnetic Resonance

Research

David G Kiely¹  Robin Condliffe¹  Charlie A Elliot¹  Jim M Wild²  Andrew J Swift³  Judith Hurdman⁴  Smitha Rajaram⁵  Dave Capener⁵ 

[1] National Institute of Health Research, Cardiovascular Biomedical Research Unit, Sheffield, UK;Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS FoundationTrust, Sheffield, UK;National Institute of Health Research, Cardiovascular Biomedical Research Unit, Sheffield, UK;Unit of Academic Radiology, University of Sheffield, Sheffield, UK;National Institute of Health Research, Cardiovascular Biomedical Research Unit, Sheffield, UK;Unit of Academic Radiology, University of Sheffield, Sheffield, UK;University of Sheffield, Academic Unit of Radiology, C Floor Royal Hallamshire Hospital, Glossop Road, S10 2J, Sheffield, UK;Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS FoundationTrust, Sheffield, UK;Unit of Academic Radiology, University of Sheffield, Sheffield, UK;

关键词: Pulmonary hypertension;    Cardiovascular magnetic resonance;    Ventricular mass index;    Late gadolinium enhancement;    Left heart disease;    Pulmonary arterial hypertension;    Right ventricle;   

DOI  :  10.1186/1532-429X-14-40

 received in 2011-12-15, accepted in 2012-06-21,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundCardiovascular Magnetic Resonance (CMR) imaging is accurate and reproducible for the assessment of right ventricular (RV) morphology and function. However, the diagnostic accuracy of CMR derived RV measurements for the detection of pulmonary hypertension (PH) in the assessment of patients with suspected PH in the clinic setting is not well described.MethodsWe retrospectively studied 233 consecutive treatment naïve patients with suspected PH including 39 patients with no PH who underwent CMR and right heart catheterisation (RHC) within 48hours. The diagnostic accuracy of multiple CMR measurements for the detection of mPAP ≥ 25 mmHg was assessed using Fisher’s exact test and receiver operating characteristic (ROC) analysis.ResultsVentricular mass index (VMI) was the CMR measurement with the strongest correlation with mPAP (r = 0.78) and the highest diagnostic accuracy for the detection of PH (area under the ROC curve of 0.91) compared to an ROC of 0.88 for echocardiography calculated mPAP. Late gadolinium enhancement, VMI ≥ 0.4, retrograde flow ≥ 0.3 L/min/m2 and PA relative area change ≤ 15% predicted the presence of PH with a high degree of diagnostic certainty with a positive predictive value of 98%, 97%, 95% and 94% respectively. No single CMR parameter could confidently exclude the presence of PH.ConclusionCMR is a useful alternative to echocardiography in the evaluation of suspected PH. This study supports a role for the routine measurement of ventricular mass index, late gadolinium enhancement and the use of phase contrast imaging in addition to right heart functional indices in patients undergoing diagnostic CMR evaluation for suspected pulmonary hypertension.

【 授权许可】

CC BY   
© Swift et al.; licensee BioMed Central Ltd. 2012