Introduction: Despite decades of initiatives, assessment of absolute pulmonary arterial pressures (PAP) by CMR has remained an elusive goal. We introduce a means to predict the PAP from routine image data easily obtained by CMR. The image data is directly used to calculate the impedance between the LV and the aorta (IMP LV ) and between the RV and the main PA (IMP RV ) which are combined to predict PAP. Methods: Patients (n=33, 82% F), 51 ±12 yrs) with a diagnosis of (PHTN) underwent evaluation by CMR to assess the blood flow through the aorta and PA at the interface to the LV and RV, respectively. Phase velocity mapping flow data at single plane (acquisition time 2min) was used to calculate the previously described and validated impedance for the LV and RV: IMP LV and IMP RV . IMP was calculated using the formula:IMP = (end systolic ejection time) x (mean blood velocity) / (vessel diameter). Systolic PAP was measured during a right heart cath examination performed within one week of the CMR. A multiple linear regression model was generated to predict systolic PAP, with parameters retained with a significance <0.05. Results: The parameters that best predicted the systolic PAP were IMP LV , IMP RV and the distance of the measured IMP LV from the center position of the data range of IMP LV (r = 0.69, p<0.001), Fig 1. The standard major-axis line was fitted to the data (p<0.001). Conclusions: This is the first demonstration of the utility of a CMR-measured left and right ventricular impedance value to directly predict systolic PAP. Critically, the correlation coefficient, identical to Echo, holds over a very wide physiologic range, and has never been demonstrated before by CMR. Of central importance is the distinguishing feature that no calibration of the data is required, thus, unlike typical Echo-derived estimates of PAP or newer implanted pressure monitors, no estimate of CVP or RAP is required. Thus, this is the first-in-man CMR demonstration of a virtual RHC.
The amount of sports news coverage is generally less for women compared to men. This serves to promote sports as a predominantly male enterprise, hindering female athletics participation and marketing. In addition, it dissuades young women from participating in sports activities, which can lead to many negative mental and physical health outcomes. This study compared athletic news coverage of male and female athletes in a local suburban newspaper and assessed factors that may influence coverage. All articles published in the weekly Lexington Minuteman in 2017 were manually reviewed extracting the sex of the athletes, sport-related factors (e.g., sport played), and publication-related factors (e.g., front-page status). A one-proportion z-test was performed to compare the proportion of articles covering male and female athletes; chi-square and t-test were used to compare factors associated with articles that covered males and females. The study found that 70% of sports-related articles covered male athletes, significantly more than females (p<0.0001). Other factors did not differ significantly by sex, including criteria for accepting articles. Although publication-related factors were similar for articles covering males and females, underrepresentation of female athletes in local newspaper coverage suggests decreased stakeholders' interest in submitting articles concerning female athletes. This may, in turn, impact female participation and interest in athletics. Improving sports consciousness needs to be addressed more widely by society to encourage female athletic participation in fitness and sports.
Introduction: In patients with pulmonary hypertension (PHTN), after initial hemodynamic assessment, it is common practice to perform the six minute walk test (6MWT). The absolute distance walked represents an integration of pulmonary artery pressure (PAP) and right heart function. Thus, the initial distance walked for each patient is generally used as the benchmark to compare to future 6MWT to assess therapy/prognosis. Here we show that the absolute 6MWT distance (6MWD) is less ambiguously interpreted as the measured impedance between the LV and the aorta. Methods: Patients (n=33, 82% F), age 51± 12yrs) with PHTN (>80% WHO I) underwent CMR to assess phasic blood flow through the aorta at the interface to the LV. CMR- phase velocity mapping flow data at single plane (acquisition time: 2min) was used to calculate the previously described and validated LV impedance (IMP LV ). IMP LV was calculated using the formula: IMP LV = (cardiac beat interval; CL) x (mean blood velocity) / (aortic diameter). Systolic PAP was measured during a right heart cath performed within one week of CMR and at the time of 6MWT. Multiple linear regression models were generated to predict the 6MWT distance. Results: A model predicting 6MWT was generated: systolic PAP, RVEF and age (r= 0.41, with PAP and RVEF not attaining significance). A second model entering IMP LV and age attained significance (r = 0.68, p<0.01). Fig 1. Conclusions: This is the first demonstration of the utility of the 6MWT distance to reflect a uniform measure of the status of the PH patient, less so PAP, even at baseline. The impedance between the LV and the aorta incorporates the dual components of RV and the LV integrated ventricular/arterial function along with the systolic PAP, making it a more fundamental measure of PHTN health status. Thus, despite >50 years of 6MWT used as the cornerstone for PHTN/PAH patients, we now show that this common application is really a predictor of impedance, and in turn, 6MWT was the right test for the wrong reason.
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