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European Heart Journal Advance Access originally published online on May 17, 2005
European Heart Journal 2005 26(19):1993-1999; doi:10.1093/eurheartj/ehi328
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Contrast enhanced-cardiovascular magnetic resonance imaging in patients with pulmonary hypertension

Kevin G. Blyth1,2, Bjoern A. Groenning2, Thomas N. Martin2, John E. Foster2, Patrick B. Mark2, Henry J. Dargie2 and Andrew J. Peacock1,*

1Scottish Pulmonary Vascular Unit, Level 8, Western Infirmary, Glasgow G11 6NT, UK
2Glasgow Cardiac Magnetic Resonance Unit, Western Infirmary, Glasgow, UK

Received 14 January 2005; revised 15 April 2005; accepted 22 April 2005; online publish-ahead-of-print 17 May 2005.

* Corresponding author. Tel: +44 0141 211 6327; fax: +44 0141 211 6334. E-mail address: apeacock{at}udcf.gla.ac.uk

Aims To determine the presence and extent of delayed contrast enhancement (DCE) in patients with pulmonary hypertension (PHT) using contrast enhanced-cardiovascular magnetic resonance imaging (ce-CMR).

Methods and results Twenty-five patients with PHT underwent ce-CMR and right heart catheterization. Right ventricular (RV) and left ventricular (LV) volumes, ejection fraction, mass, and DCE mass were determined with ce-CMR. Mean pulmonary artery pressure (mean PAP) averaged 43 (12) mmHg and cardiac output 4.3 (1.2) L/min. DCE was demonstrated in 23 out of 25 patients. DCE was confined to the RV insertion points (RVIPs) in seven patients and extended into the interventricular septum (IVS) in the remaining 16 patients. In these 16 patients, septal contrast enhancement was associated with IVS bowing. The extent of contrast enhancement correlated positively with RV end-diastolic volume/body surface area, RV mass, mean PAP, and pulmonary vascular resistance and correlated inversely with RV ejection fraction.

Conclusion DCE was present within the RVIPs and IVS of most patients with PHT studied. Extent of DCE correlated with RV function and pulmonary haemodynamics. DCE was associated with IVS bowing and may provide a novel marker for occult septal abnormalities directly relating to the haemodynamic stress experienced by these patients.

Key Words: Pulmonary hypertension • Cardiovascular magnetic resonance imaging • Right ventricle • Gadolinium


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