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Open Access 01-12-2023 | Magnetic Resonance Imaging | Original Article

Right and left ventricular blood pool T2 ratio on cardiac magnetic resonance imaging correlates with hemodynamics in patients with pulmonary hypertension

Authors: Mei Deng, Anqi Liu, Wenqing Xu, Haoyu Yang, Qian Gao, Ling Zhang, Yanan Zhen, Xiaopeng Liu, Wanmu Xie, Min Liu

Published in: Insights into Imaging | Issue 1/2023

Abstract

Objectives

Our objective is to compare the right/left ventricular blood pool T1 ratio (RVT1/LVT1), and right/left ventricular blood pool T2 ratio (RVT2/LVT2) on Cardiac Magnetic Resonance Imaging (CMR) between patients with pulmonary hypertension (PH) and normal controls, to analyze the correlation of RVT1/LVT1, RVT2/LVT2 and hemodynamics measured with right heart catheterization (RHC) in patients with PH.

Methods

Forty two patients with PH and 40 gender-and age-matched healthy controls were prospectively included. All patients underwent RHC and CMR within 24 h. The right and left ventricular blood pool T1 and T2 values were respectively measured, and RVT1/LVT1 and RVT2/LVT2 between the PH group and the healthy control were compared. Meanwhile, the correlation between RVT1/LVT1, RV/LVT2 ratio and hemodynamic parameters in patients with PH respectively was analyzed.

Results

In the control group, RVT2 was significantly lower than LVT2 (t = 6.782, p < 0.001) while RVT1 also was lower than LVT1 (t = 8.961, p < 0.001). In patients with PH, RVT2 was significantly lower than LVT2 (t = 9.802, p < 0.001) while RVT1 was similar to LVT1 (t = − 1.378, p = 0.176). RVT2/LVT2 in the PH group was significantly lower than that in the control group (p < 0.001). RVT1/LVT1 in PH patients increased in comparison with the control group (p < 0.001). RVT2/LVT2 negatively correlated with pulmonary vascular resistance (r = − 0.506) and positively correlated with cardiac index (r = 0.521), blood oxygen saturation in Superior vena cava, right atrium, right ventricle and pulmonary artery (r = 0.564, 0.603, 0.648, 0.582).

Conclusions

RVT2/LVT2 on T2 mapping could be an additional CMR imaging marker that may assist to evaluate the severity of PH.

Humbert M, Kovacs G, Hoeper MM et al (2022) ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Respir J 2022:2200879. https://doi.org/10.1183/13993003.00879-2022CrossRef

Freed BH, Collins JD, François CJ et al (2016) MR and CT imaging for the evaluation of pulmonary hypertension. JACC Cardiovasc Imaging 9:715–732. https://doi.org/10.1016/j.jcmg.2015.12.015CrossRefPubMedPubMedCentral

Garg P, Lewis RA, Johns CS et al (2021) Cardiovascular magnetic resonance predicts all-cause mortality in pulmonary hypertension associated with heart failure with preserved ejection fraction. Int J Cardiovasc Imaging 37:3019–3025. https://doi.org/10.1007/s10554-021-02279-z. (Epub 2021 May 12)CrossRefPubMedPubMedCentral

Contaldi C, Capuano F, Romano L et al (2021) Cardiovascular magnetic resonance in right heart and pulmonary circulation disorders. Heart Fail Clin 17:57–75. https://doi.org/10.1016/j.hfc.2020.08.006CrossRefPubMed

Diao KY, Yang ZG, Xu HY et al (2016) Histologic validation of myocardial fibrosis measured by T1 mapping: a systematic review and meta-analysis. J Cardiovasc Magn Reson 18:92. https://doi.org/10.1186/s12968-016-0313-7CrossRefPubMedPubMedCentral

Schelbert EB, Messroghli DR (2016) State of the art: clinical applications of cardiac T1 mapping. Radiology 278:658–676. https://doi.org/10.1148/radiol.2016141802CrossRefPubMed

García-Álvarez A, García-Lunar I, Pereda D et al (2015) Association of myocardial T1-mapping CMR with hemodynamics and RV performance in pulmonary hypertension. JACC Cardiovasc Imaging 8:76–82. https://doi.org/10.1016/j.jcmg.2014.08.012CrossRefPubMed

Roller FC, Wiedenroth C, Breithecker A et al (2017) Native T1 mapping and extracellular volume fraction measurement for assessment of right ventricular insertion point and septal fibrosis in chronic thromboembolic pulmonary hypertension. Eur Radiol 27:1980–1991. https://doi.org/10.1007/s00330-016-4585-yCrossRefPubMed

Roller FC, Kriechbaum S, Breithecker A et al (2019) Correlation of native T1 mapping with right ventricular function and pulmonary haemodynamics in patients with chronic thromboembolic pulmonary hypertension before and after balloon pulmonary angioplasty. Eur Radiol 29:1565–1573. https://doi.org/10.1007/s00330-018-5702-xCrossRefPubMed

10.

Giri S, Chung YC, Merchant A et al (2009) T2 quantification for improved detection of myocardial edema. J Cardiovasc Magn Reson 11:56. https://doi.org/10.1186/1532-429X-11-56CrossRefPubMedPubMedCentral

11.

Nishii T, Kono AK, Shigeru M et al (2014) Cardiovascular magnetic resonance T2 mapping can detect myocardial edema in idiopathic dilated cardiomyopathy. Int J Cardiovasc Imaging 30(Suppl 1):65–72. https://doi.org/10.1007/s10554-014-0414-zCrossRefPubMed

12.

O’Brien AT, Gil KE, Varghese J et al (2022) T2 mapping in myocardial disease: a comprehensive review. J Cardiovasc Magn Reson 24:33. https://doi.org/10.1186/s12968-022-00866-0CrossRefPubMedPubMedCentral

13.

Wright GA, Hu BS, Macovski A (1991) Estimating oxygen saturation of blood in vivo with MR imaging at 1.5 T. J Magn Reson Imaging 1(3):275–283. https://doi.org/10.1002/jmri.1880010303CrossRefPubMed

14.

Varghese J, Potter LC, LaFountain R et al (2017) CMR-based blood oximetry via multi-parametric estimation using multiple T2 measurements. J Cardiovasc Magn Reson 19:88. https://doi.org/10.1186/s12968-017-0403-1CrossRefPubMedPubMedCentral

15.

Saini BS, Darby JRT, Portnoy S et al (2020) Normal human and sheep fetal vessel oxygen saturations by T2 magnetic resonance imaging. J Physiol 598:3259–3281. https://doi.org/10.1113/JP279725CrossRefPubMed

16.

Emrich T, Bordonaro V, Schoepf UJ et al (2022) Right/left ventricular blood pool T2 ratio as an innovative cardiac MRI screening tool for the identification of left-to-right shunts in patients with right ventricular disease. J Magn Reson Imaging 55:1452–1458. https://doi.org/10.1002/jmri.27881CrossRefPubMed

17.

Thulborn KR, Waterton JC, Matthews PM et al (1982) Oxygenation dependence of the transverse relaxation time of water protons in whole blood at high field. Biochim Biophys Acta 714:265–270. https://doi.org/10.1016/0304-4165(82)90333-6CrossRefPubMed

18.

Rodrígue-Szoto AE, Abdulmalik O, Langham MC, Schwartz N, Lee H, Wehrli FW (2018) T2 ‐prepared balanced steady‐state free precession (bSSFP) for quantifying whole‐blood oxygen saturation at 1.5T. Magn Reson Med 79(4):1893–1900. https://doi.org/10.1002/mrm.26835CrossRef

19.

Nield LE, Qi X, Yoo SJ et al (2002) MRI-based blood oxygen saturation measurements in infants and children with congenital heart disease. Pediatr Radiol 32:518–522. https://doi.org/10.1007/s00247-001-0652-9CrossRefPubMed

20.

van Leeuwen FHP, Lena B, Zwanenburg JJM et al (2021) Detecting low blood concentrations in joints using T1 and T2 mapping at 1.5, 3, and 7 T: an in vitro study. Eur Radiol Exp. https://doi.org/10.1186/s41747-021-00251-zCrossRefPubMedPubMedCentral

21.

Portnoy S, Seed M, Sled JG et al (2017) Non-invasive evaluation of blood oxygen saturation and hematocrit from T1 and T2 relaxation times: In-vitro validation in fetal blood. Magn Reson Med 78:2352–2359. https://doi.org/10.1002/mrm.26599CrossRefPubMed

Title: Right and left ventricular blood pool T2 ratio on cardiac magnetic resonance imaging correlates with hemodynamics in patients with pulmonary hypertension
Authors: Mei Deng
Anqi Liu
Wenqing Xu
Haoyu Yang
Qian Gao
Ling Zhang
Yanan Zhen
Xiaopeng Liu
Wanmu Xie
Min Liu
Publication date: 01-12-2023
Publisher: Springer Vienna
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Pulmonary Hypertension
Pulmonary Hypertension
Pulmonary Hypertension
Pulmonary Hypertension
Published in: Insights into Imaging / Issue 1/2023
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-023-01406-9

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Springer Medicine

Right and left ventricular blood pool T2 ratio on cardiac magnetic resonance imaging correlates with hemodynamics in patients with pulmonary hypertension

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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