Characterization of Pulmonary Arterial Hypertension Using Right Ventricular Regional Curvedness Derived from CMR Imaging

Abstract

Pulmonary arterial hypertension (PAH) is a hemodynamic and pathophysiological condition defined as mean pulmonary artery pressure greater than 25 mmHg at rest by right heart catheterization (RHC). PAH may develop decompensated hemodynamics leading to progressive right ventricular (RV) dilation, shape alteration, dysfunction and failure. However, quantification of RV shape is challenging due to its complex geometry. We proposed using geometry based curvedness index at the end-systole phase (CES) computed from cardiac magnetic resonance (CMR) imaging to characterize PAH patients. All participants underwent CMR imaging and the 3D RV geometry were reconstructed in the form of a triangulated surface mesh partitioned into 13 segments based on our previous works. Our preliminary results are: There is a significant difference in CES for free-wall segments aggregated across the basal, mid-layer and apical regions for the PAH and control groups (p < 0.05). For the mid-layer region, the mean CES for free-wall segments for PAH patients with New York Heart Association (NYHA) class 2 is significantly different as compared to the control group (p<0.05). Similarly, for the apical region, the mean CES for free-wall segments in PAH patients in NYHA class 2 and 3 are also significantly different as compared to the control group (p < 0.05).