Background: Cardiac magnetic resonance (CMR) has promise of being able to provide frequent cardiac morphology and function evaluations noninvasively for repeated follow-ups of pulmonary arterial hypertension (PAH) patients after the initial right heart catheterization (RHC) diagnosis. By using the noninvasive CMR indices, the present study aimed to formulate and validate a prediction model of mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR).
Methods: Both Derivation Cohort (N=25) and Validation Cohort (N=25) of PAH patients underwent CMR and RHC within one week. Fast cine and phase-contrast sequences were used to calculate CMR indices, including ventricular mass index (VMI), interventricular septum curvature ratio (CR), and positive pulmonary arterial flow (Q). The gold standard mPAP (mPAP) and PVR (PVR) were measured from RHC. mPAP was calculated using CMR indices (mPAP) from the Derivation Cohort. Multiple linear regression was applied for analysis.
Results: The equation predicting mPAP was mPAP=28.837VMI-26.479CR-0.201Q+57.021. The equation was then applied to the Validation Cohort to verify the accuracy of the prediction equation. mPAP was correlated linearly with mPAP as mPAP=0.8055mPAP+7.9056 (r=0.6470, p<0.001). Moreover, PVR calculated from CMR (PVR) was also correlated with the PVR in both the Derivation Cohort (r=0.4092, p<0.001) and the Validation Cohort (r=0.3480, p<0.001).
Conclusion: The application of the mPAP and PVR technique could potentially provide a noninvasive method to evaluate the hemodynamics for PAH patients during follow-ups as well as right ventricle function assessment.
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