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Reiter, G; Reiter, U; Kovacs, G; Kainz, B; Schmidt, K; Maier, R; Olschewski, H; Rienmueller, R.
Magnetic Resonance-Derived 3-Dimensional Blood Flow Patterns in the Main Pulmonary Artery as a Marker of Pulmonary Hypertension and a Measure of Elevated Mean Pulmonary Arterial Pressure
CIRC-CARDIOVASC IMAGING. 2008; 1(1): 23-30. Doi: 10.1161/CIRCIMAGING.108.780247 [OPEN ACCESS]
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Führende Autor*innen der Med Uni Graz
Reiter Gert
Co-Autor*innen der Med Uni Graz
Kovacs Gabor
Maier Robert
Olschewski Horst
Reiter Ursula
Rienmüller Rainer
Schmidt Karin
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Abstract:
BACKGROUND: Pulmonary hypertension is a disease characterized by an elevation in pulmonary arterial pressure that is diagnosed invasively via right heart catheterization. Such pathological altered pressures in the pulmonary vascular system should lead to changes in blood flow patterns in the main pulmonary artery. METHODS AND RESULTS: Forty-eight subjects (22 with manifest pulmonary hypertension, 13 with latent pulmonary hypertension, and 13 normal control subjects) underwent time-resolved 3D magnetic resonance phase-contrast imaging of the main pulmonary artery. Velocity fields that resulted from measurements were calculated, visualized, and analyzed with dedicated software. Main findings were as follows: (1) Manifest pulmonary hypertension coincides with the appearance of a vortex of blood flow in the main pulmonary artery (sensitivity and specificity of 1.00, 95% confidence intervals of 0.84 to 1.00 and 0.87 to 1.00, respectively), and (2) the relative period of existence of the vortex correlates significantly with mean pulmonary arterial pressure at rest (correlation coefficient of 0.94). To test the diagnostic performance of the vortex criterion, we furthermore investigated 55 patients in a blinded prospective study (22 with manifest pulmonary hypertension, 32 with latent pulmonary hypertension, and 1 healthy subject), which resulted in a sensitivity of 1.00 and specificity of 0.91 (95% confidence intervals of 0.84 to 1.00 and 0.76 to 0.98, respectively). Comparison of catheter-derived mean pulmonary artery pressure measurements and calculated mean pulmonary artery pressure values resulted in a standard deviation of differences of 3.6 mm Hg. CONCLUSIONS: Vortices of blood flow in the main pulmonary artery enable the identification of manifest pulmonary hypertension. Elevated mean pulmonary arterial pressures can be measured from the period of vortex existence.
Find related publications in this database (using NLM MeSH Indexing)
Adolescent - administration & dosage
Adult - administration & dosage
Aged - administration & dosage
Aged, 80 and over - administration & dosage
Blood Flow Velocity - administration & dosage
Blood Pressure - administration & dosage
Cardiac Catheterization - administration & dosage
Case-Control Studies - administration & dosage
Female - administration & dosage
Humans - administration & dosage
Hypertension, Pulmonary - diagnosis, physiopathology
Imaging, Three-Dimensional - administration & dosage
Magnetic Resonance Angiography - administration & dosage
Male - administration & dosage
Middle Aged - administration & dosage
Predictive Value of Tests - administration & dosage
Prospective Studies - administration & dosage
Pulmonary Artery - physiopathology
Pulmonary Circulation - administration & dosage
Regional Blood Flow - administration & dosage
Sensitivity and Specificity - administration & dosage
Single-Blind Method - administration & dosage
Young Adult - administration & dosage

Find related publications in this database (Keywords)
hypertension, pulmonary
magnetic resonance imaging
blood flow
blood pressure
catheterization
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