Easily measurable, noninvasive, and novel finding for pulmonary hypertension: Hypertrophy of the basal segment of septomarginal trabeculation of right ventricle.
BACKGROUND
Effect of pulmonary hypertension (PH) on right ventricular (RV) geometry constitutes an ideal target to assess both pulmonary artery pressure (PAP) and its physiological importance. In this study, we evaluated the diagnostic power of the basal segment of septomarginal trabeculation (SMT) in predicting the PH and RV hypertrophy by cardiovascular magnetic resonance (CMR) in patients with idiopathic pulmonary arterial hypertension (IPAH) and Eisenmenger's syndrome (ES).


METHODS
Eleven patients with IPAH, seven patients with ES, and 20 healthy controls were enrolled. CMR was used to measure the area and the thickness of the basal segment of SMT and right ventricular free wall (RVFW). Pulmonary artery systolic pressures (PASPs) were estimated by transthoracic echocardiography (TTE) with continuous-wave Doppler analysis measuring maximal tricuspid regurgitation (TR) velocity. Late gadolinium enhancement (LGE) findings of CMR and brain natriuretic peptide (BNP) levels were also obtained in all patients and control group.


RESULTS
The area and the thickness of the basal segment of SMT were higher in patients with IPAH and ES than control group (P<.001). Pulmonary artery dimension, end-diastolic diameter of RV, RVFW thickness, and BNP levels were found to be significantly correlated with PAP (P<.001). LGE was present at the insertion point of RV only in patients group (P<.001).


CONCLUSIONS
Increased area and thickness of the basal segment of SMT are easily measurable noninvasive markers of PH in patients with IPAH and ES.
Department of Cardiology, Acibadem Maslak Hospital, Istanbul, Turkey.
Gultekin
http://orcid.org/0000-0002-0705-8243
G
Karakus
Department of Cardiology, Acibadem University School of Medicine, Istanbul, Turkey.
Ertugrul
E
Zencirci
Department of Cardiology, Acibadem University School of Medicine, Istanbul, Turkey.
Aleks
A
Degirmencioglu
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey.
Tolga Sinan
TS
Güvenc
Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Hale
H
Unal Aksu
Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Aydin
A
Yildirim
D000328:Adult; D065627:Familial Primary Pulmonary Hypertension / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005240:Feasibility Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D017380:Hypertrophy, Right Ventricular / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D015203:Reproducibility of Results; D013318:Stroke Volume / Q000502:physiology
cardiovascular magnetic resonance; pulmonary hypertension; septomarginal trabeculation