Noninvasive Measurement of Pulmonary Vascular Resistances by Assessment of Cardiac Output and Pulmonary Transit Time

Müller, H.; Tripolt, Michael; Rehak, Peter; Groell, Reinhard; Rienmüller, R.; Tscheliessnigg, Karlheinz

doi:10.1097/00004424-200012000-00006

Cited by 27 publications

(26 citation statements)

References 21 publications

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“…It was recognized more than half a century ago, using invasive methods, that global circulation time, from systemic vein to systemic artery, is prolonged in patients with heart failure. [7][8][9] More recent studies have confirmed earlier observations using modern technologies such as nuclear scintigraphy, 10,11 computed tomography, 12 and magnetic resonance (MR) angiography. 13 To date, studies of segmental circulation time have been limited to measurements of transit time between pulmonary artery and left atrium (LA), 8 pulmonary artery and ascending aorta 13,14 or to femoral artery, 15 or antecubital vein and peripheral tissues.…”

Section: Clinical Perspective On P 138mentioning

confidence: 55%

“…Early observations as well as more recent studies have demonstrated a relationship between prolongation of various indices of circulation time and LV enlargement, LV dysfunction, reduced cardiac output, and congestive heart failure. [7][8][9][10][11][12][13][14][15][16][17] To our knowledge, this is the first study to explore the hemodynamic significance of LA circulation transit time. The measurement of LATT by CMR is derived from the ratio of volume to flow, based on the principles of indicator dilution theory.…”

Section: Discussionmentioning

confidence: 99%

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Left Ventricular Filling Pressure Assessment Using Left Atrial Transit Time by Cardiac Magnetic Resonance Imaging

Cao

Wang

McLaughlin

et al. 2011

Circ: Cardiovascular Imaging

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Background-Left atrial (LA) size and function reflect left ventricular (LV) hemodynamics. In the present study, we developed a novel method to determine LA circulation transit time (LATT) by MRI and demonstrated its close association with LV filling pressure. Methods and Results-All subjects were prospectively recruited and underwent contrast-enhanced MR dynamic imaging.Mean LATT was determined as the time for contrast to transit through the LA during the first pass. In an invasive study group undergoing clinically indicated cardiac catheterization (nϭ25), LATT normalized by R-R interval (nLATT) was closely associated with LV early diastolic pressure (rϭ0.

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Section: Clinical Perspective On P 138mentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Left Ventricular Filling Pressure Assessment Using Left Atrial Transit Time by Cardiac Magnetic Resonance Imaging

Cao

Wang

McLaughlin

et al. 2011

Circ: Cardiovascular Imaging

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“…Electron beam computed tomography (CT) has been used to quantify the PTT and cardiac output, the latter based on the product of the planimetrically determined stroke volume and heart rate ( 33 ). However, researchers in that study did not calculate the PBV by using their data.…”

Section: Stroke Volume Ejection Fraction Pbv and Pbv Variationmentioning

confidence: 99%

Pulmonary Blood Volume Variation Decreases after Myocardial Infarction in Pigs: A Quantitative and Noninvasive MR Imaging Measure of Heart Failure

Kanski¹,

Engblom²,

Götberg³

et al. 2010

Radiology

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“…3,4 Dynamic contrast-enhanced (DCE) time-resolved magnetic resonance (MR) imaging is a technique whereby an intravenous contrast bolus can be tracked through the cardiopulmonary vascular system in three dimensions with time. [5][6][7][8][9][10][11][12] Several previous studies have assessed DCE-MR in patients with pulmonary hypertension, 8,9,[13][14][15] and significant correlations have been identified between timeresolved DCE-MR angiography and invasive prognostic indicators. However, the role of DCE-MR pulmonary vascular transit time (TT) measurements as prognostic markers in PAH has not yet been determined.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Contrast–Enhanced Magnetic Resonance Imaging in Patients with Pulmonary Arterial Hypertension

et al. 2014

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Dynamic contrast-enhanced (DCE) time-resolved magnetic resonance (MR) imaging is a technique whereby the passage of an intravenous contrast bolus can be tracked through the pulmonary vascular system. The aim of this study was to investigate the prognostic significance of DCE-MR pulmonary blood transit times in patients with pulmonary arterial hypertension (PAH). Seventy-nine patients diagnosed with PAH underwent pulmonary DCE imaging at 1.5 T using a time-resolved three-dimensional spoiled gradient echo sequence. The prognostic significance of two DCE parameters, full width at half maximum (FWHM) of the first-pass clearance curve and pulmonary transit time (PTT), along with demographic and invasive catheter measurements, was evaluated by univariate and bivariate Cox proportional hazards regression and Kaplan-Meier analysis. DCE-MR transit times were most closely correlated with cardiac index (CI) and pulmonary vascular resistance index (PVRI) and were both found to be accurate for detecting reduced CI (FWHM area under the curve [AUC] at receiver operating characteristic analysis = 0.91 and PTT AUC = 0.92, respectively) and for detecting elevated PVRI (FWHM AUC = 0.88 and PTT AUC = 0.84, respectively). During the follow-up period, 25 patients died. Patients with longer measurements of FWHM (P = 0.0014) and PTT (P = 0.004) were associated with poor outcome at Kaplan-Meier analysis, and both parameters were strong predictors of adverse outcome from Cox proportional hazards analysis (P = 0.013 and 0.010, respectively). At bivariate analysis, DCE measurements predicted mortality independent of age, gender, and World Health Organization functional class; however, invasive hemodynamic indexes CI, PVRI, and DCE measurements were not independent of one another. In conclusion, DCE-MR transit times predict mortality in patients with PAH and are closely associated with clinical gold standards CI and PVRI.

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Noninvasive Measurement of Pulmonary Vascular Resistances by Assessment of Cardiac Output and Pulmonary Transit Time

Abstract: The formula created seems to allow a clinically valid estimate of pulmonary vascular resistance from noninvasively acquired data.

Cited by 27 publications

References 21 publications

Left Ventricular Filling Pressure Assessment Using Left Atrial Transit Time by Cardiac Magnetic Resonance Imaging

Left Ventricular Filling Pressure Assessment Using Left Atrial Transit Time by Cardiac Magnetic Resonance Imaging

Pulmonary Blood Volume Variation Decreases after Myocardial Infarction in Pigs: A Quantitative and Noninvasive MR Imaging Measure of Heart Failure

Dynamic Contrast–Enhanced Magnetic Resonance Imaging in Patients with Pulmonary Arterial Hypertension

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