Abstract
PURPOSE: To investigate the potential of 4D flow MRI-derived pulmonary hemodynamic parameters as sensitive markers for chronic obstructive pulmonary disease (COPD) patients with right ventricular dysfunction (RVD). METHODS: We enrolled 15 COPD patients combined with RVD and 43 non-RVD participants, all of them underwent pulmonary function tests, thoracic CT and cardiac MR examinations, and the image post-processing analysis was completed. After comparing the 2 groups, the average flow velocity of the main pulmonary artery (Vavg-MPA) and the right pulmonary artery (Vavg-RPA) were identified as statistically significant confounding factors, propensity score matching was used to pair patients controlling for these 2 parameters. Univariate and multivariate logistic regression analyses were performed to assess the pulmonary hemodynamic parameters obtained from 4D flow MRI that could serve as sensitive markers for identifying COPD patients with RVD based on the matched participants dataset. RESULTS: Fourteen COPD patients combined with RVD and 29 non-RVD participants were successfully matched. Logistic regression analysis showed that the decreased systolic pressure drop along the MRA-RPA tract (odds ratio [OR]: 0.31; 95% confidence interval [CI]: 0.12-0.78; P =0.013) and the presence of vortex (OR: 8.82; 95% CI: 1.11-70.36; P =0.040) were identified as independent risk factors for RVD in COPD patients. CONCLUSION: Pulmonary hemodynamic parameters derived from 4D flow MRI, specifically the systolic pressure drop along the MPA-RPA tract and the presence of vortex in the main pulmonary artery, can serve as sensitive indicators for predicting right ventricular dysfunction in COPD patients.