Quantification of right ventricular extracellular volume in pulmonary hypertension using cardiac magnetic resonance imaging

P. Habert (1) , T. Capron (1) , S. Hubert (2) , Z. Bentatou (1) , A. Bartoli (2) , F. Tradi (3) , S. Renard (4) , S. Rapacchi (1) , Maxime Guye (5, 1) , Monique Bernard (1) , G. Habib (6, 2) , A. Jacquier (1)

1 CRMBM - Centre de résonance magnétique biologique et médicale
2 APHM - Assistance Publique - Hôpitaux de Marseille
3 TIMONE - Hôpital de la Timone [CHU - APHM]
4 ST-CROLLES - STMicroelectronics [Crolles]
5 CEMEREM - Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - AP-HM]
6 MEPHI - Microbes évolution phylogénie et infections

Purpose The purpose of this prospective study was to assess the value of biventricular extracellular volume (ECV) in pre-capillary pulmonary hypertension (PH) obtained using cardiac magnetic resonance imaging (CMR) and to correlate ECV with markers of prognosis such as strain echocardiography and blood biomarkers of fibrosis. Materials and methods Twelve patients with PH (6 men, 6 women; mean age = 50 ± 16 [SD] years; age range: 22–73 years) underwent the same day: (i), transthoracic echocardiography including measurement of right ventricular (RV) fractional shortening (RVfs), tricuspid annular plane systolic excursion (TAPSE), maximal tricuspid annular velocity, RV global and segmental deformation; (ii), right heart catheterization measuring pulmonary arterial pressures (in mmHg) and cardiac output (in L/min); (iii), CMR at 1.5-T measuring RV volumes and ejection fraction; (iv), native and 15 min post-contrast T1 mapping using modified look-locker inversion-recovery sequence; and (v), serum quantification of two biomarkers of collagen turnover and hematocrit. Non-parametric Mann-Whitney tests were used to search for differences between categorical variables. Spearman correlation test was used for search for correlation between quantitative values. Results Global RV ECV was 34% ± 4.2 (SD) for our entire population. A significant correlation was found between RV ECV and RVfs (r = 0.6; P = 0.026), S wave velocity (r = 0.7; P = 0.009), TAPSE (r = 0.6; P = 0.040) and RV systolic ejection fraction on CMR (r = 0.6; P = 0.04). There were no correlations between the ECV values in the lateral wall of the RV and in the septum (r = 0.4; P = 0.206). A significant correlation was found between septal ECV and 2D septal strain (r = 0.7; P = 0.013). Conclusion ECV in PH as obtained using CMR appears to correlate with known echocardiographic prognostic markers and more specifically with the markers, which assess RV systolic function.

Keywords: Extracellular volume; T1 mapping; Hypertension; Pulmonary; Cardiac magnetic resonance imaging (CMR); Fibrosis

Domains: Life Sciences [q-bio]; Microbiology and Parasitology; Bacteriology; Life Sciences [q-bio]; Microbiology and Parasitology; Virology; Life Sciences [q-bio]; Microbiology and Parasitology; Parasitology; Life Sciences [q-bio]; Human health and pathology; Cardiology and cardiovascular system; Life Sciences [q-bio]; Human health and pathology; Emerging diseases; Life Sciences [q-bio]; Human health and pathology; Infectious diseases

P. Habert, T. Capron, S. Hubert, Z. Bentatou, A. Bartoli, et al.. Quantification of right ventricular extracellular volume in pulmonary hypertension using cardiac magnetic resonance imaging. Diagnostic and Interventional Imaging, 2020, 101 (5), pp.311-320. ⟨10.1016/j.diii.2019.12.008⟩. ⟨hal-02457050⟩