Contrast enhanced-cardiovascular magnetic resonance imaging in patients with pulmonary hypertension.
OBJECTIVE
To determine the presence and extent of delayed contrast enhancement (DCE) in patients with pulmonary hypertension (PHT) using contrast enhanced-cardiovascular magnetic resonance imaging (ce-CMR).


RESULTS
Twenty-five patients with PHT underwent ce-CMR and right heart catheterization. Right ventricular (RV) and left ventricular (LV) volumes, ejection fraction, mass, and DCE mass were determined with ce-CMR. Mean pulmonary artery pressure (mean PAP) averaged 43 (12) mmHg and cardiac output 4.3 (1.2) L/min. DCE was demonstrated in 23 out of 25 patients. DCE was confined to the RV insertion points (RVIPs) in seven patients and extended into the interventricular septum (IVS) in the remaining 16 patients. In these 16 patients, septal contrast enhancement was associated with IVS bowing. The extent of contrast enhancement correlated positively with RV end-diastolic volume/body surface area, RV mass, mean PAP, and pulmonary vascular resistance and correlated inversely with RV ejection fraction.


CONCLUSIONS
DCE was present within the RVIPs and IVS of most patients with PHT studied. Extent of DCE correlated with RV function and pulmonary haemodynamics. DCE was associated with IVS bowing and may provide a novel marker for occult septal abnormalities directly relating to the haemodynamic stress experienced by these patients.
Blyth
Kevin G
KG
Scottish Pulmonary Vascular Unit, Level 8, Western Infirmary, Glasgow G11 6NT, UK.
Groenning
Bjoern A
BA
Martin
Thomas N
TN
Foster
John E
JE
Mark
Patrick B
PB
Dargie
Henry J
HJ
Peacock
Andrew J
AJ
D006328:Cardiac Catheterization / Q000379:methods; D003287:Contrast Media; D003430:Cross-Sectional Studies; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged
D003287:Contrast Media; D019786:Gadolinium DTPA