Cardiovascular magnetic resonance-derived left ventricular intraventricular pressure gradients among patients with precapillary pulmonary hypertension.

Autor:	Vos JL; Department of Cardiology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands., Leiner T; Department of Radiology, Mayo Clinic, Rochester, MN, USA.; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands., van Dijk APJ; Department of Cardiology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands., Pedrizzetti G; Department of Engineering and Architecture, University of Trieste, Trieste, Italy., Alenezi F; Department of Cardiology, Duke Heart Center, Durham, NC, USA., Rodwell L; Department of Health Sciences, section Biostatistics, Radboud Institute for Health Sciences, Nijmegen, the Netherlands., van der Wegen CTPM; Department of Cardiology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands., Post MC; Department of Cardiology, St. Antonius, Nieuwegein, The Netherlands., Driessen MMP; Department of Cardiology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.; Department of Radiology, Mayo Clinic, Rochester, MN, USA., Nijveldt R; Department of Cardiology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA Nijmegen, The Netherlands.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2022 Dec 19; Vol. 24 (1), pp. 78-87.
DOI:	10.1093/ehjci/jeab294
Abstrakt:	Aims: Precapillary pulmonary hypertension (pPH) affects left ventricular (LV) function by ventricular interdependence. Since LV ejection fraction (EF) is commonly preserved, LV dysfunction should be assessed with more sensitive techniques. Left atrial (LA) strain and estimation of LV intraventricular pressure gradients (IVPG) may be valuable in detecting subtle changes in LV mechanics; however, the value of these techniques in pPH is unknown. Therefore, the aim of our study is to evaluate LA strain and LV-IVPGs from cardiovascular magnetic resonance (CMR) cines in pPH patients. Methods and Results: In this cross-sectional study, 31 pPH patients and 22 healthy volunteers underwent CMR imaging. Feature-tracking LA strain was measured on four- and two-chamber cines. LV-IVPGs (from apex-base) are computed from a formulation using the myocardial movement and velocity of the reconstructed 3D-LV (derived from long-axis cines using feature-tracking). Systolic function, both LV EF and systolic ejection IVPG, was preserved in pPH patients. Compared to healthy volunteers, diastolic function was impaired in pPH patients, depicted by (i) lower LA reservoir (36 ± 7% vs. 26 ± 9%, P < 0.001) and conduit strain (26 ± 6% vs. 15 ± 8%, P < 0.001) and (ii) impaired diastolic suction (-9.1 ± 3.0 vs. ‒6.4 ± 4.4, P = 0.02) and E-wave decelerative IVPG (8.9 ± 2.6 vs. 5.7 ± 3.1, P < 0.001). Additionally, 11 pPH patients (35%) showed reversal of IVPG at systolic-diastolic transition compared to none of the healthy volunteers (P = 0.002). Conclusions: pPH impacts LV function by altering diastolic function, demonstrated by an impairment of LA phasic function and LV-IVPG analysis. These parameters could therefore potentially be used as early markers for LV functional decline in pPH patients. Competing Interests: Conflict of interest: none declared. (© Crown copyright 2022.)
Databáze:	MEDLINE
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