4D flow cardiac MRI to assess pulmonary blood flow in patients with pulmonary arterial hypertension associated with congenital heart disease.

Autor: Valdeolmillos E; Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Faculté de Médecine, Université Paris Saclay, 92350 Le Plessis-Robinson, France; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremin-Bicêtre, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France. Electronic address: evaldeolmillos@ghpsj.fr., Sakhi H; Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Faculté de Médecine, Université Paris Saclay, 92350 Le Plessis-Robinson, France; Department of Cardiology, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Faculté de Médecine, Université Paris Saclay, 92350 Le Plessis-Robinson, France; Department of Radiology, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Université Paris-Saclay, 92350 Le Plessis-Robinson, France., Tortigue M; Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Faculté de Médecine, Université Paris Saclay, 92350 Le Plessis-Robinson, France., Audié M; Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Faculté de Médecine, Université Paris Saclay, 92350 Le Plessis-Robinson, France., Isorni MA; Department of Radiology, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Université Paris-Saclay, 92350 Le Plessis-Robinson, France., Lecerf F; Research and Innovation Department, Marie Lannelongue Hospital, Paris Saclay University, 92350 Le Plessis-Robinson, France., Sitbon O; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremin-Bicêtre, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; Department of Respiratory and Intensive Care Medicine, Reference Centre for Pulmonary Hypertension, Hôpital Bicêtre, 94270 Le Kremlin-Bicêtre, France., Montani D; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremin-Bicêtre, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; Department of Respiratory and Intensive Care Medicine, Reference Centre for Pulmonary Hypertension, Hôpital Bicêtre, 94270 Le Kremlin-Bicêtre, France., Jais X; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremin-Bicêtre, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; Department of Respiratory and Intensive Care Medicine, Reference Centre for Pulmonary Hypertension, Hôpital Bicêtre, 94270 Le Kremlin-Bicêtre, France., Savale L; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremin-Bicêtre, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; Department of Respiratory and Intensive Care Medicine, Reference Centre for Pulmonary Hypertension, Hôpital Bicêtre, 94270 Le Kremlin-Bicêtre, France., Humbert M; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremin-Bicêtre, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; Department of Respiratory and Intensive Care Medicine, Reference Centre for Pulmonary Hypertension, Hôpital Bicêtre, 94270 Le Kremlin-Bicêtre, France., Azarine A; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremin-Bicêtre, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France; Department of Radiology, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Université Paris-Saclay, 92350 Le Plessis-Robinson, France., Hascoët S; Department of Congenital Heart Diseases, Centre de Référence Malformations Cardiaques Congénitales Complexes M3C, Hôpital Marie Lannelongue, Groupe Hospitalier Paris Saint-Joseph, Faculté de Médecine, Université Paris Saclay, 92350 Le Plessis-Robinson, France; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremin-Bicêtre, France; Inserm UMR-S 999, Hôpital Marie Lannelongue, 92350 Le Plessis-Robinson, France.
Jazyk: angličtina
Zdroj: Diagnostic and interventional imaging [Diagn Interv Imaging] 2024 Jul-Aug; Vol. 105 (7-8), pp. 266-272. Date of Electronic Publication: 2024 Feb 16.
DOI: 10.1016/j.diii.2024.01.009
Abstrakt: Purpose: The purpose of this study was to evaluate the accuracy of four-dimensional flow cardiac magnetic resonance imaging (4D flow MRI) compared to right heart catheterization in measuring pulmonary flow (Qp), systemic flow (Qs) and pulmonary-to-systemic flow ratio (Qp/Qs) in patients with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD).
Materials and Methods: The study was registered on Clinical-trial.gov (NCT03928002). Sixty-four patients with PAH-CHD who underwent 4D flow MRI were included. There were 16 men and 48 women with a mean age of 45.3 ± 13.7 (standard deviation [SD]) years (age range: 21-77 years). Fifty patients (50/64; 78%) presented with pre-tricuspid shunt. Qp (L/min), Qs (L/min) and Qp/Qs were measured invasively using direct Fick method during right heart catheterization and compared with measurements assessed by 4D flow MRI within a 24-48-hour window.
Results: The average mean pulmonary artery pressure was 51 ± 17 (SD) mm Hg with median pulmonary vascular resistance of 8.8 Wood units (Q1, Q3: 5.3, 11.7). A strong linear correlation was found between Qp measurements obtained with 4D flow MRI and those obtained with the Fick method (r = 0.96; P < 0.001). Bland Altman analysis indicated a mean difference of 0.15 ± 0.48 (SD) L/min between Qp estimated by 4D flow MRI and by right heart catheterization. A strong correlation was found between Qs and Qp/Qs measured by 4D flow MRI and those obtained with the direct Fick method (r = 0.85 and r = 0.92; P < 0.001 for both).
Conclusion: Qp as measured by 4D flow MRI shows a strong correlation with measurements derived from the direct Fick method. Further investigation is needed to develop less complex and standardized methods for measuring essential PAH parameters, such as pulmonary arterial pressures and pulmonary vascular resistance.
Competing Interests: Declaration of competing interest The authors declare no actual or potential conflict of interest related to this study.
(Copyright © 2024 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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