Improved diagnostic accuracy of MRI in patients with suspected pulmonary hypertension with combined right ventricle and pulmonary artery metrics

Introduction: An MRI model derived from right ventricular (RV) measurements has been proposed for the evaluation of mean pulmonary arterial pressure (mPAP) with MRI has been proposed in the evaluation of patients with pulmonary hypertension (PH). The aim of this study was to estimate mPAP using MRI using metrics from both the RV and pulmonary artery (PA). Methods: A derivation cohort of 300 consecutive patients with suspected PH underwent RHC and MRI within 48 hours. An estimate of mPAP was derived using multivariate regression analysis of MRI measurements. The model was tested in an independent validation cohort of 140 patients with suspected PH. Comparative diagnostic accuracy of estimated mPAP derived from RV and PA indices, versus estimated mPAP derived from RV metrics alone was assessed. Results: The derivation cohort included 247 patients with PH and 53 patients with mPAP Conclusion: In addition to RV indices, PA diastolic area and relative area change measured by MRI, have incremental value for estimation of mPAP. A model using RV and PA metrics improves diagnostic accuracy over RV measurements alone.