title: Pulmonary Artery Stiffness Is Independently Associated with Right Ventricular Mass and Function: A Cardiac MR Imaging Study.
abstract: Purpose To determine the relationship between pulmonary artery (PA) stiffness and both right ventricular (RV) mass and function with cardiac magnetic resonance (MR) imaging. Materials and Methods The study was approved by the local research ethics committee, and all participants gave written informed consent. Cardiac MR imaging was performed at 1.5 T in 156 healthy volunteers (63% women; age range, 19-61 years; mean age, 36.1 years). High-temporal-resolution phase-contrast imaging was performed in the main and right PAs. Pulmonary pulse wave velocity (PWV) was determined by the interval between arterial systolic upslopes. RV function was assessed with feature tracking to derive peak systolic strain and strain rate, as well as peak early-diastolic strain rate. RV volumes, ejection fraction (RVEF), and mass were measured from the cine images. The association of pulmonary PWV with RV function and mass was quantified with univariate linear regression. Interstudy repeatability was assessed with intraclass correlation. Results The repeatability coefficient for pulmonary PWV was 0.96. Increases in pulmonary PWV and RVEF were associated with increases in age (r = 0.32, P < .001 and r = 0.18, P = .025, respectively). After adjusting for age (P = .090), body surface area (P = .073), and sex (P = .005), pulmonary PWV demonstrated an independent positive association with RVEF (r = 0.34, P = .026). Significant associations were also seen with RV mass (r = 0.41, P = .004), RV radial strain (r = 0.38, P = .022), and strain rate (r = 0.35, P = .002), and independent negative associations were seen with radial (r = 0.27, P = .003), longitudinal (r = 0.40, P = .007), and circumferential (r = 0.31, P = .005) peak early-diastolic strain rate with the same covariates. Conclusion Pulmonary PWV is reliably assessed with cardiac MR imaging. In subjects with no known cardiovascular disease, increasing PA stiffness is associated with increasing age and is also moderately associated with both RV mass and function after controlling for age, body surface area, and sex. (©) RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Timothy J W
authors.initials: TJ
authors.lastname: Dawes
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Ajay
authors.initials: A
authors.lastname: Gandhi
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Antonio
authors.initials: A
authors.lastname: de Marvao
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Rui
authors.initials: R
authors.lastname: Buzaco
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Paweł
authors.initials: P
authors.lastname: Tokarczuk
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Marina
authors.initials: M
authors.lastname: Quinlan
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Giuliana
authors.initials: G
authors.lastname: Durighel
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Tamara
authors.initials: T
authors.lastname: Diamond
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Laura
authors.initials: L
authors.lastname: Monje Garcia
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Alain
authors.initials: A
authors.lastname: de Cesare
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Cook
authors.affiliation: From the Medical Research Council Clinical Sciences Centre, Faculty of Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, England (T.J.W.D., A.d.M., R.B., P.T., M.Q., G.D., T.D., L.M.G., S.A.C., D.P.O'R.); Department of Cardiology, Imperial College NHS Healthcare Trust, London, England (A.G.); and Sorbonne Universités, UPMC Univ Paris 06, INSERM UMR_S 1146, CNRS UMR 7371, Lib, Paris, France (A.d.C.);
authors.forename: Declan P
authors.initials: DP
authors.lastname: O'Regan
mesh_terms: D000328:Adult; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D055815:Young Adult