CMR评估肺高血压：肺高血压患者与健康志愿者对照研究

BACKGROUND AND OBJECTIVE: The clinical course of pulmonary hypertension (PH) is one of progressive deterioration interspersed with episodes of acute decompensation. It is difficult to predict when patients will die because death may come either suddenly or slowly due to progressive heart failure. The aim of this study is to investigate morphology, function and hemodynamics in PH, compared with healthy people, and to investigate the clinical value of detection of PH by use of cardiac magnetic resonance (CMR) parameters. METHODS: CMR was performed in 56 PH patients collected from Tianjin Medical University General Hospital from January 2012 to December 2014 and 22 healthy controls. The following parameters were calculated: right ventricle (RV) end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), myocardial mass (MM), RV fractional area change (RVFAC), interventricular septal curvature (C(IVS)), left ventricular free wall curvature (C(FW)), and C(IVS)/C(FW), main pulmonary artery (MPA) positive peak velocity, maximal area, minimal area and distensibility. Comparisons of CMR measurements between PH patients and controls were analyzed by using the student t-tests. Receiver operating characteristic (ROC) curve analysis was used to compare the PH diagnostic abilities for four parameters (MPA positive peak velocity, distensibility, curvature ratio, and RVFAC) and combined CMR parameter. P < 0.05 was considered significant. RESULTS: Compared with healthy controls, RV morphology, function and hemodynamics of PH group declined and deteriorate obviously. The ROC curve analysis showed that among the four parameters distensibility of MPA had the highest AUC value (AUC=0.95). Additionally, combined CMR parameter (positive peak velocity+distensibility+curvature ratio+RVFAC) had even higher AUC (AUC=0.988). CONCLUSION: Comprehensive CMR parameters is conducive to accurately reflect the overall state RV-pulmonary circulation in patients with PH.