Octavia Bane1, Sanjiv J Shah2, Michael J Cuttica3, Jeremy D Collins4, Senthil Selvaraj5, Neil R Chatterjee6, Christoph Guetter7, James C Carr4, Timothy J Carroll8. 1. Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai Hospital, New York, NY; Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL; Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL. 2. Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, IL. 3. Division of Pulmonary and Critical Care, Feinberg School of Medicine, Northwestern University, Chicago, IL. 4. Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL. 5. Feinberg School of Medicine, Northwestern University, Chicago, IL. 6. Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL; Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL; Feinberg School of Medicine, Northwestern University, Chicago, IL. 7. Siemens Corporation, Corporate Research, Princeton, NJ. 8. Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL; Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL. Electronic address: t-carroll@northwestern.edu.
Abstract
PURPOSE: We propose a method for non-invasive quantification of hemodynamic changes in the pulmonary arteries resulting from pulmonary hypertension (PH). METHODS: Using a two-element Windkessel model, and input parameters derived from standard MRI evaluation of flow, cardiac function and valvular motion, we derive: pulmonary artery compliance (C), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), pulmonary capillary wedge pressure (PCWP), time-averaged intra-pulmonary pressure waveforms and pulmonary artery pressures (systolic (sPAP) and diastolic (dPAP)). MRI results were compared directly to reference standard values from right heart catheterization (RHC) obtained in a series of patients with suspected pulmonary hypertension (PH). RESULTS: In 7 patients with suspected PH undergoing RHC, MRI and echocardiography, there was no statistically significant difference (p<0.05) between parameters measured by MRI and RHC. Using standard clinical cutoffs to define PH (mPAP>25mmHg), MRI was able to correctly identify all patients as having pulmonary hypertension, and to correctly distinguish between pulmonary arterial (mPAP>25mmHg, PCWP<15mmHg) and venous hypertension (mPAP>25mmHg, PCWP>15mmHg) in 5 of 7 cases. CONCLUSIONS: We have developed a mathematical model capable of quantifying physiological parameters that reflect the severity of PH.
PURPOSE: We propose a method for non-invasive quantification of hemodynamic changes in the pulmonary arteries resulting from pulmonary hypertension (PH). METHODS: Using a two-element Windkessel model, and input parameters derived from standard MRI evaluation of flow, cardiac function and valvular motion, we derive: pulmonary artery compliance (C), mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), pulmonary capillary wedge pressure (PCWP), time-averaged intra-pulmonary pressure waveforms and pulmonary artery pressures (systolic (sPAP) and diastolic (dPAP)). MRI results were compared directly to reference standard values from right heart catheterization (RHC) obtained in a series of patients with suspected pulmonary hypertension (PH). RESULTS: In 7 patients with suspected PH undergoing RHC, MRI and echocardiography, there was no statistically significant difference (p<0.05) between parameters measured by MRI and RHC. Using standard clinical cutoffs to define PH (mPAP>25mmHg), MRI was able to correctly identify all patients as having pulmonary hypertension, and to correctly distinguish between pulmonary arterial (mPAP>25mmHg, PCWP<15mmHg) and venous hypertension (mPAP>25mmHg, PCWP>15mmHg) in 5 of 7 cases. CONCLUSIONS: We have developed a mathematical model capable of quantifying physiological parameters that reflect the severity of PH.
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