1. Can MRI detect pulmonary hypertension in a population pre-selected by echocardiography?
- Author
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Damien Voilliot, Laurent Bonnemains, Freddy Odille, Jacques Felblinger, Ari Chaouat, François Chabot, Clément Venner, Service de Cardiologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pneumologie [CHRU Nancy], Centre d'Investigation Clinique - Innovation Technologique [Nancy] (CIC-IT), Centre d'investigation clinique [Nancy] (CIC), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie Cardiaque [CHU Strasbourg], and CHU Strasbourg
- Subjects
Male ,Cardiac Catheterization ,[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Logistic regression ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Second line ,pulmonary hypertension ,030212 general & internal medicine ,Cardiac catheterization ,education.field_of_study ,Ejection fraction ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,Limits of agreement ,General Medicine ,Stroke volume ,Middle Aged ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Echocardiography ,Cardiology ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Hypertension, Pulmonary ,Population ,Pulmonary Artery ,Pulmonary arterial pressure ,03 medical and health sciences ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,medicine.artery ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Arterial Pressure ,Magnetic resonance imaging (MRI) ,education ,business.industry ,Magnetic resonance imaging ,Stroke Volume ,medicine.disease ,Pulmonary hypertension ,Blood pressure ,Ventricle ,Pulmonary artery ,diagnostic power ,business - Abstract
Background The place of magnetic resonance imaging (MRI) in the assessment of pulmonary hypertension (PH) remains controversial. Several studies proposed to use MRI to assess pulmonary pressure but the level of proof is low. Purpose To evaluate the diagnostic power of cardiac MRI within a non-selected population of patients suspected of PH after an echocardiography. Material and Methods Fifty-six consecutive patients, suspected of PH after an echocardiography, were assessed with right heart catheterization and cardiac MRI (including a high temporal resolution pulmonary flow curve). We extracted from the MRI data the main parameters proposed by all precedent studies available in the literature. We looked for multivariate linear relations between those parameters and the mean pulmonary arterial pressure (mPAP), and eventually assessed with a logit regression the ability of those parameters to diagnose PH in our population. Results The multivariate model retained only two parameters: the right ventricle ejection fraction and the pulmonary trunk minimum area. The prediction of mPAP (r2 = 0.5) yielded limits of agreement of 15 mmHg. However, the prediction of PH within the population was feasible and the method yielded a specificity of 80% for a sensitivity of 100%. Conclusion The performance of MRI to assess mPAP is too low to be used as a replacement for right heart catheterization but MRI could be used as second line examination after echocardiography to avoid right heart catheterization for normal patients.
- Published
- 2018