Cardio-pulmonary MRI for detection of treatment response after a single BPA treatment session in CTEPH patients.
Aged
Angioplasty, Balloon
/ methods
Cardiac Output
/ physiology
Female
Humans
Hypertension, Pulmonary
/ diagnostic imaging
Magnetic Resonance Angiography
/ methods
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Natriuretic Peptide, Brain
/ blood
Peptide Fragments
/ blood
Pulmonary Artery
/ diagnostic imaging
Pulmonary Circulation
/ physiology
Pulmonary Embolism
/ diagnostic imaging
Retrospective Studies
Treatment Outcome
Ventricular Function, Right
/ physiology
Balloon angioplasty
Heart
Magnetic resonance imaging
Perfusion
Pulmonary hypertension
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Apr 2019
Apr 2019
Historique:
received:
06
05
2018
accepted:
31
07
2018
revised:
16
07
2018
pubmed:
13
10
2018
medline:
7
5
2019
entrez:
13
10
2018
Statut:
ppublish
Résumé
Chronic thromboembolic pulmonary hypertension (CTEPH) can be treated with balloon pulmonary angioplasty (BPA) in inoperable patients. Sensitive non-invasive imaging methods are missing to detect treatment response after a single BPA treatment session. Therefore, the aim of this study was to measure treatment response after a single BPA session using cardio-pulmonary MRI. Overall, 29 patients with CTEPH were examined with cardio-pulmonary MRI before and 62 days after their initial BPA session. Pulmonary blood flow (PBF), first-pass bolus kinetic parameters, and biventricular mass and function were determined. Multiple linear regression analysis was implemented to estimate the relationship of PBF change in the treated lobe with treatment change of full width at half maximum (FWHM), cardiac output (CO), ventricular mass index (VMI), pulmonary transit time (PTT) and PBF change in the non-treated lobes. Paired Wilcoxon rank sum test and Spearman rho correlation were used. After BPA regional PBF increased in the treated lobe (p < 0.0001) as well as in non-treated lobes (p = 0.015). PBF treatment changes in the treated lobe were significantly larger compared with the non-treated lobes (p = 0.0049). Change in NT proBNP, MRI-derived mean pulmonary artery pressure (mPAP), PTT, FWHM, right ventricular (RV) ejection fraction, RV stroke volume, CO, VMI and PBF in the non-treated lobes correlated with PBF change in the treated lobe (p < 0.05). PBF changes in the treated lobe were independently predicted by PTT as well as PBF change in the non-treated lobes. Cardio-pulmonary MRI detects and quantifies treatment response after a single BPA treatment session. • Two months after BPA regional parenchymal pulmonary perfusion (PBF) increased in the total lung parenchyma (p = 0.005), the treated lobes (p < 0.0001) and non-treated lobes (p = 0.015). • The PBF treatment changes in the treated lobe were significantly larger than in the non-treated lobes (p = 0.0049). • Change in NT proBNP, MRI-derived mean pulmonary artery pressure, pulmonary transit time, full width at half maximum, right ventricular (RV) ejection fraction, RV stroke volume, cardiac output, ventricular mass index and PBF in the non-treated lobes correlated with PBF change in the treated lobe (p < 0.05).
Identifiants
pubmed: 30311032
doi: 10.1007/s00330-018-5696-4
pii: 10.1007/s00330-018-5696-4
doi:
Substances chimiques
Peptide Fragments
0
pro-brain natriuretic peptide (1-76)
0
Natriuretic Peptide, Brain
114471-18-0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1693-1702Références
J Am Coll Cardiol. 2010 Jun 8;55(23):2614-62
pubmed: 20513610
Eur Radiol. 2016 Oct;26(10):3617-25
pubmed: 26795615
Eur Respir J. 2013 Mar;41(3):735-42
pubmed: 23143539
Phys Med Biol. 2007 Jan 21;52(2):429-47
pubmed: 17202625
Eur Respir Rev. 2012 Mar 1;21(123):32-9
pubmed: 22379172
Invest Radiol. 2010 Jan;45(1):7-14
pubmed: 19996761
Radiology. 2012 Jun;263(3):678-87
pubmed: 22509050
J Am Coll Cardiol. 2013 Dec 24;62(25 Suppl):D92-9
pubmed: 24355646
Circulation. 2011 Nov 1;124(18):1973-81
pubmed: 21969018
Chest. 2007 Feb;131(2):402-9
pubmed: 17296640
Eur Radiol. 2007 Jan;17(1):11-21
pubmed: 16838142
Cardiovasc Intervent Radiol. 2016 Jan;39(1):53-63
pubmed: 25828726
Eur Respir Rev. 2013 Dec;22(130):526-34
pubmed: 24293468
Eur Radiol. 2017 Oct;27(10):4264-4270
pubmed: 28361177
Int J Cardiol. 2016 Jan 15;203:228-35
pubmed: 26519672
Eur J Radiol. 2017 Apr;89:270-276
pubmed: 28034568
Eur Heart J. 2016 Jan 1;37(1):67-119
pubmed: 26320113
Radiology. 2016 Jun;279(3):925-34
pubmed: 26727392
Pulm Circ. 2014 Mar;4(1):61-70
pubmed: 25006422
Circulation. 2014 Aug 5;130(6):508-18
pubmed: 25092279
Circ J. 2016 May 25;80(6):1470-7
pubmed: 27097557
J Am Coll Cardiol. 1985 Apr;5(4):918-27
pubmed: 3973294
Circ Cardiovasc Interv. 2012 Dec;5(6):748-55
pubmed: 23192917
J Thorac Cardiovasc Surg. 2011 Mar;141(3):702-10
pubmed: 21335128
Thorax. 2013 Jul;68(7):677-8
pubmed: 23349220
Eur Radiol. 2016 Nov;26(11):4064-4071
pubmed: 26905868
Circulation. 2000 Aug 22;102(8):865-70
pubmed: 10952954
Invest Radiol. 2011 Sep;46(9):567-75
pubmed: 21577127
Circulation. 2016 May 3;133(18):1731-3
pubmed: 27052412
Circulation. 2009 Sep 15;120(11):992-1007
pubmed: 19752350
Lancet Respir Med. 2016 May;4(5):372-80
pubmed: 27067478
JACC Cardiovasc Imaging. 2013 Oct;6(10):1036-1047
pubmed: 23769494
J Interv Cardiol. 2017 Jun;30(3):249-255
pubmed: 28474349
Int J Cardiol. 2015 Mar 15;183:138-42
pubmed: 25662076
Eur Respir J. 2017 Jun 8;49(6):
pubmed: 28596435
Lancet Respir Med. 2014 Jul;2(7):573-82
pubmed: 24898750
Respir Med. 2007 Nov;101(11):2254-62
pubmed: 17706409
J Comput Assist Tomogr. 2006 May-Jun;30(3):426-32
pubmed: 16778617
JACC Cardiovasc Interv. 2014 Nov;7(11):1297-306
pubmed: 25459043
Int J Cardiol. 2015 Sep 15;195:19-26
pubmed: 26011408