4D-flow MRI assessment of blood flow before and after endovascular intervention in a patient with pulmonary hypertension due to isolated pulmonary artery involvement in large vessel vasculitis

Kamada, Hiroki; Ota, Hideki; Aoki, Tatsuo; Sugimura, Koichiro; Yaoita, Nobuhiro; Shimokawa, Hiroaki; Takase, Kei

doi:10.1016/j.radcr.2019.11.019

Cited by 7 publications

(8 citation statements)

References 19 publications

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“…Kamada et al reported that stent treatment for unilateral pulmonary artery stenosis in large-vessel vasculitis resulted in an increase in overall pulmonary blood flow and improved blood flow balance between the right and left pulmonary arteries. 61 In CTEPH patients, 4D flow MRI allows for the demonstration of drastic changes in pulmonary blood flow after pulmonary thromboendarterectomy and BPA (Fig. 2e and 2f).…”

Section: Hemodynamic Effects Of Percutaneous Intervention For Group I...mentioning

confidence: 99%

Clinical Application of 4D Flow MR Imaging to Pulmonary Hypertension

et al. 2022

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Pulmonary hypertension (PH) is characterized by elevated pulmonary arterial pressure (PAP). Although rightheart catheterization is the gold standard method for the diagnosis of PH by definition, various less-invasive imaging tests have been used for screening, detection of underlying diseases-causing PH, and monitoring of diseases. Among them, 4D flow MRI is an emerging and unique imaging test that allows for comprehensive visualization of blood flow in the right heart and proximal pulmonary arteries. The characteristic blood flow pattern observed in patients with PH is vortical flow formation in the main pulmonary artery. Recent studies have proposed the use of these findings to determine not only the presence of PH but also estimate the mean PAP. Other applications of 4D flow MRI for PH include measurement of wall shear stress, helicity, and 3D flow balance in the pulmonary arteries. It is worth noting that 4D flow has also the potential for longitudinal followups. In this review, the clinical definition of PH, summary of conventional imaging tests, characteristics of pulmonary arterial flow as shown by 4D flow MRI, and clinical application of 4D flow MRI in the management of patients with PH will be discussed.

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Section: Hemodynamic Effects Of Percutaneous Intervention For Group I...mentioning

confidence: 99%

Clinical Application of 4D Flow MR Imaging to Pulmonary Hypertension

et al. 2022

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“…A variety of related proteins and acute phase proteins are expressed in the plasma of patients with TA, which can also be used to determine the different stages of the disease, and which are worthy of further discussion. In addition, the N-terminal pro-brain natriuretic peptide (NT pro-BNP) level was significantly higher in the PH group than the non-PH group, which may be related to the wide range of pulmonary artery lesions (22)(23)(24).…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of pulmonary artery involvement in patients with Takayasu arteritis between pulmonary hypertension and non-pulmonary hypertension

Lei¹,

Li²,

Wang³

et al. 2023

Ann Transl Med

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Background: Multiple Takayasu arteritis (TA) is a chronic non-specific large to medium vasculitis disease that mainly accumulates the aorta and its branches. Pulmonary vascular disease is often seen as stenosis and occlusion, and patients may show no moderate to severe pulmonary hypertension. The study sought to summarize the clinical characteristics of patients with pulmonary hypertension (PH) involving the pulmonary artery caused by TA.Methods: Twenty-nine patients with TA treated at the General Hospital of Ningxia Medical University from September 2009 to December 2021 were collected. All the patients had TA involving the pulmonary artery, and were divided into the PH group (n=17 patients) and the non-PH group (n=12). The diagnoses of pulmonary Takayasu arteritis (PTA) were used the 1990 diagnostic criteria of the American Rheumatic Association and the 1996 improved Ishikawa diagnostic criteria. Computed tomography angiography (CTA) of the patients after treatment was determined, and the laboratory tests, echocardiography, pulmonary and systemic artery angiography were assessed. Results:The patients had an average age of onset of 33.5 [19-60] years. All the cases of PH were confirmed by echocardiography and it was suggested that the bilateral side easier to involve pulmonary arteries than the unilateral side, and the right side than the left side. At admission, the ESR and N pro-BNP level of the PH group did not differ significantly to those of the non-PH Group. There were significant differences between the two groups in patients in terms of the type II of TA imaging diagnosis (P=0.030). The accuracy of diagnosing PH with bilateral pulmonary vascular involvement was significantly higher in the PH group than the non-PH group (P=0.003). The diagnostic accuracy of pulmonary vascular lumen obstruction in the PH group was significant difference (P<0.05). The diagnostic accuracy of pleural effusion in the PH group was significantly higher than that of the non-PH group (P=0.001) for lung field signs. The diameters of the right atrium and pulmonary artery differed significantly between the two groups (P=0.013).Conclusions: Patients with TA involving the pulmonary artery mainly complained of shortness of breath.Most of these patients had PH.

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“…These results suggest that the efficacy of BPA may be smaller for patients with TA-PH and PPS compared with that in CTEPH [13]. In 2020, Kamada et al reported a patient of suspected TA with isolated pulmonary artery involvement complicated with severe PH, who underwent successful stent placement for stenosis in the right main pulmonary artery [19]. Mean PAP decreased from 45 to 22 mmHg and a concomitant increase in overall pulmonary blood flow, evaluated by 4D-flow cardiovascular magnetic resonance [19].…”

Section: Efficacy Of Bpa On Ta and Ppsmentioning

confidence: 99%

Balloon Pulmonary Angioplasty for Takayasu Arteritis and Peripheral Pulmonary Artery Stenosis Mimicking Chronic Thromboembolic Pulmonary Hypertension

Fukui

Shirota

Nakano

et al. 2022

Life

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Balloon pulmonary angioplasty (BPA) has been reported to be effective and safe to an acceptable level in patients with distal-type, inoperable chronic thromboembolic pulmonary hypertension (CTEPH), resulting in improved long-term survival. However, evidenced treatment options and strategy including medical therapy of antithrombotic therapy, glucocorticoids, immunosuppressants, and pulmonary hypertension (PH)-specific therapies are scarce in patients with significant PH and right heart failure associated with Takayasu arteritis and peripheral pulmonary artery stenosis, both of which mimic CTEPH. Moreover, there has been still concern on safety and lack of established methodology in performing BPA for these conditions. In this report, we would like to review recent publications including several case reports and discuss the efficacy, safety, and suitable methods of BPA in this population.

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4D-flow MRI assessment of blood flow before and after endovascular intervention in a patient with pulmonary hypertension due to isolated pulmonary artery involvement in large vessel vasculitis

Cited by 7 publications

References 19 publications

Clinical Application of 4D Flow MR Imaging to Pulmonary Hypertension

Clinical Application of 4D Flow MR Imaging to Pulmonary Hypertension

Clinical characteristics of pulmonary artery involvement in patients with Takayasu arteritis between pulmonary hypertension and non-pulmonary hypertension

Balloon Pulmonary Angioplasty for Takayasu Arteritis and Peripheral Pulmonary Artery Stenosis Mimicking Chronic Thromboembolic Pulmonary Hypertension

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