Correlation of native T1 mapping with right ventricular function and pulmonary haemodynamics in patients with chronic thromboembolic pulmonary hypertension before and after balloon pulmonary angioplasty
The aim of this study was to assess native T1 mapping in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) before and 6 months after balloon pulmonary angioplasty (BPA) and compare the results with right heart function and pulmonary haemodynamics.
Magnetic resonance imaging at 1.5 T and right heart catheterisation were performed in 21 consecutive inoperable CTEPH patients before and 6 months after BPA. T1 values were measured within the septal myocardium, the upper and lower right ventricular insertion points, and the lateral wall at the basal short-axis section. In addition, the area-adjusted septal native T1 time (AA-T1) was calculated and compared with right ventricular function (RVEF), mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR).
The mean AA-T1 value decreased significantly after BPA (1,045.8 ± 44.3 ms to 1,012.5 ± 50.4 ms; p < 0.001). Before BPA, native T1 values showed a moderate negative correlation with RVEF (r = -0.61; p = 0.0036) and moderate positive correlations with mPAP (r = 0.59; p < 0.01) and PVR (r = 0.53; p < 0.05); after BPA correlation trends were present (r = -0.21, r = 0.30 and r = 0.35, respectively).
Native T1 values in patients with inoperable CTEPH were significantly lower after BPA and showed significant correlations with RVEF and pulmonary haemodynamics before BPA. Native T1 mapping seems to be indicative of reverse myocardial tissue remodelling after BPA and might therefore have good potential for pre-procedural patient selection, non-invasive therapy monitoring and establishing a prognosis.
• BPA is a promising treatment option for patients with inoperable CTEPH
• Native septal T1 values significantly decrease after BPA and show good correlations with right ventricular function and haemodynamics before BPA
• Prognosis and non-invasive therapy monitoring might be supported in the future by native T1 mapping
KeywordsMagnetic resonance imaging Pulmonary hypertension Pulmonary embolism Angioplasty
Area-adjusted native T1 time
Balloon pulmonary angioplasty
Cardiac magnetic resonance imaging
Chronic thromboembolic pulmonary hypertension
Mean pulmonary arterial pressure
Pulmonary vascular resistance
Right ventricular function
Right ventricular insertion point
We are grateful to Elizabeth Martinson, PhD, from the KHFI Editorial Office for her editorial assistance.
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Prof. Dr. Gabriele A. Krombach.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional review board approval was obtained.
• prognostic study/observational/experimental
• performed at one institution
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