TY - JOUR T1 - Improved diagnostic accuracy of MRI in patients with suspected pulmonary hypertension with combined right ventricle and pulmonary artery metrics JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2015.PA2457 VL - 46 IS - suppl 59 SP - PA2457 AU - Andrew Swift AU - Angela Lungu AU - Henry Walker AU - Dave Capener AU - Charlotte Hammerton AU - Charlie Elliot AU - Robin Condliffe AU - David Kiely AU - Jim Wild Y1 - 2015/09/01 UR - http://erj.ersjournals.com/content/46/suppl_59/PA2457.abstract N2 - Introduction: An MRI model derived from right ventricular (RV) measurements has been proposed for the evaluation of mean pulmonary arterial pressure (mPAP) with MRI has been proposed in the evaluation of patients with pulmonary hypertension (PH). The aim of this study was to estimate mPAP using MRI using metrics from both the RV and pulmonary artery (PA).Methods: A derivation cohort of 300 consecutive patients with suspected PH underwent RHC and MRI within 48 hours. An estimate of mPAP was derived using multivariate regression analysis of MRI measurements. The model was tested in an independent validation cohort of 140 patients with suspected PH. Comparative diagnostic accuracy of estimated mPAP derived from RV and PA indices, versus estimated mPAP derived from RV metrics alone was assessed.Results: The derivation cohort included 247 patients with PH and 53 patients with mPAP <25mmHg,and the validation cohort included 115 patients with PH and 25 patients with mPAP<25mmHg. The following composite statistical model of mPAP was derived: MRI estimated mPAP= -21.806 + (inter-ventricular septal angle x 0.31) + (ventricular mass index x 11.5) + (Diastolic pulmonary artery area x 0.01) – (PA relative area change x 0.22). In the validation cohort, the area under the receiver operator curve was 0.92 (0.87 to 0.97) for the model based on RV and PA indices and 0.86 (0.79 to 0.92) for measurements made from the RV alone.Conclusion: In addition to RV indices, PA diastolic area and relative area change measured by MRI, have incremental value for estimation of mPAP. A model using RV and PA metrics improves diagnostic accuracy over RV measurements alone. ER -