Pulmonary artery distensibility in pulmonary arterial hypertension: a MRI pilot study

¹ Pulmonary Division, Pulmonary Hypertension Unit, Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil
² Fleury Research Institute, Sao Paulo, Brazil
³ Centre des Maladies Vasculaires Pulmonaires, UPRES EA 2705, Hôpital Antoine Béclère, Université Paris-Sud, Clamart, France
⁴ Pulmonary and Critical Care Division, University of Washington
⁵ Pulmonary Division, Pulmonary Hypertension Unit, Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil; Fleury Research Institute, Sao Paulo, Brazil; and Centre des Maladies Vasculaires Pulmonaires, UPRES EA 2705, Hôpital Antoine Béclère, Université Paris-Sud, Clamart, France

^* To whom correspondence should be addressed. E-mail: rgrsz{at}uol.com.br.

	Abstract

Pulmonary arterial hypertension is a disease of the small vessels in which there is substantial increase in pulmonary vascular resistance, leading to right ventricle failure and death.

Invasive hemodynamic evaluation is mandatory not only for diagnosis confirmation but also to address prognosis and eligibility to the use of calcium channel blockers through an acute vasodilator challenge. Non-invasive surrogate response markers to the acute vasodilator test have been sought. In this study, we investigated the relationships between pulmonary artery distensibility (assessed by magnetic resonance imaging) and response to acute vasodilator test.

Nineteen patients diagnosed with idiopathic pulmonary arterial hypertension without any specific treatment were evaluated. In a 48 hours window after pulmonary artery catheterization, patients underwent cardiac magnetic resonance imaging.

Cardiac index, calculated after the determination of cardiac output, invasively and non-invasively have shown excellent correlation(r=0.72; p<0.05), as well as right atrial pressure and right ventricle ejection fraction (r= -0.60; p<0.01). Pulmonary artery distensibility was significantly higher in responders(p=0.01). A receiver-operating characteristic curve analysis has shown that 10% distensibility was able to distinguish responders from non-responders with 100% sensitivity 56% specificity. These findings suggest that magnetic resonance and pulmonary artery distensibility may be noninvasive useful tools for evaluation of patients with pulmonary hypertension.

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