Comparison of pulmonary circulation parameters acquired by cardiovascular magnetic resonance with right heart catheterization and transthoracic echocardiography in patients with recent-onset dilated cardiomyopathy

对近期发病扩张型心肌病患者,通过心血管磁共振、右心导管检查和经胸超声心动图获取的肺循环参数进行比较

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Abstract

INTRODUCTION: Evaluating pulmonary circulation parameters (PCP) with cardiovascular magnetic resonance (CMR) is a relatively new approach with the potential for complex evaluation of the cardio-pulmonary system. Its impact might complement clinical assessment through right heart catheterization (RHC), the gold standard in evaluating pulmonary hypertension (PH) and hemodynamics, and transthoracic echocardiography (TTE). The study aims to examine the correlation between PCP and diastolic and systolic function, as well as PH, in patients with recent-onset dilated cardiomyopathy (RODCM). METHODS: Eighty-four patients with RODCM were retrospectively included. All patients had a CMR examination, RHC (including pulmonary capillary wedge pressure (PCWP) and pulmonary vascular resistance (PVR)), and TTE. The pulmonary transit time (PTT), corrected pulmonary transit time (PTTc), systolic and diastolic function, and PH were assessed. Patients were divided into groups according to the PH and the diastolic function. RESULTS: PTT and PTTc correlated with PCWP, cardiac index, PVR, and E/e'. Patients with a restrictive filling pattern showed significantly longer PTT. The receiver operating characteristic curves for PTT, PTTc, and PH were assessed with areas under the curve of 72.7% for PTT and 75.3% for PTTc, and cut-off values of 8.62 s (PTT) and 8.52 s (PTTc). CONCLUSION: To our knowledge, this is the first study focused on CMR-derived PCP in an RODCM group. Our findings show that PTT and PTTc are prolonged in patients with impaired systolic and diastolic function, and PH. Therefore, PCP might offer critical information to evaluate the cardio-pulmonary system comprehensively.

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