CMR-based estimation of mean pulmonary arterial pressure and pulmonary vascular resistance in connective tissue disease-associated pulmonary arterial hypertension

IF 2 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology Pub Date : 2026-02-01 Epub Date: 2025-12-02 DOI:10.1016/j.crad.2025.107199

K. Ma , Y. Zhu , W. Liu , X. Zhu , Q. Wang , X. Sun , Y. Guo , Y. Wang , Y. Zhu , Y. Xu

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引用次数: 0

Abstract

Purpose

To estimate mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) using cardiac magnetic resonance (CMR) in connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH).

Materials and Methods

This retrospective study included 144 CTD patients (50 CTD-nonPAH, 70 CTD-PAH derivation, 24 CTD-PAH validation) from September 2017 to March 2024. Patients underwent both CMR and right heart catheterization (RHC) within 7 days. CMR parameters, including ventricular volumes, and pulmonary arterial hemodynamics, were measured and compared with RHC-derived mPAP and PVR. Multivariate regression models for mPAP and PVR were developed and validated. Spearman's correlation and Bland-Altman analysis were used to assess model accuracy.

Results

Ventricular mass index (VMI), interventricular septum (IVS) angle, and IVS curvature correlated strongly with RHC-based mPAP (r=0.73, 0.71, and –0.69; all P<0.01). A right ventricular ejection fraction (RVEF) threshold of 22 % was identified: when RVEF > 22 %, mPAP and RVEF were negatively correlated (P<0.001); no correlation was found when RVEF ≤ 22 % (P=0.657). For RVEF > 22 %, the following CMR model was established to predict mPAP: 32.454 + (42.616 × VMI) – (19.276 × IVS curvature). Another CMR model for predicting PVR was developed: 8.664 + (28.495 × VMI) − (0.053 × RVESVI) − (7.206 × RV SV/ESV). Validation demonstrated good correlations with RHC (mPAP: r=0.679; PVR: r=0.625, both P≤0.001). Bland-Altman analysis confirmed agreement between CMR and RHC.

Conclusions

CMR provides a noninvasive method for estimating mPAP and PVR in CTD-PAH patients, with potential utility in pulmonary hemodynamic assessment.

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基于cmr的结缔组织病相关肺动脉高压患者平均肺动脉压和肺血管阻力评估

目的应用心脏磁共振（CMR）评估结缔组织病相关性肺动脉高压（CTD-PAH）患者的平均肺动脉压（mPAP）和肺血管阻力（PVR）。材料与方法本回顾性研究纳入2017年9月至2024年3月144例CTD患者（50例CTD-非pah， 70例CTD- pah衍生，24例CTD- pah验证）。患者在7天内接受CMR和右心导管（RHC）。测量CMR参数，包括心室容积和肺动脉血流动力学，并与rhc衍生的mPAP和PVR进行比较。建立并验证了mPAP和PVR的多元回归模型。采用Spearman相关和Bland-Altman分析来评估模型的准确性。结果心室质量指数（VMI）、室间隔角（IVS）和IVS曲率与基于rhc的mPAP相关性较强（r=0.73、0.71和-0.69;p < 0.01）。右心室射血分数（RVEF）阈值为22%：当RVEF >； 22%时，mPAP和RVEF呈负相关（P<0.001）；RVEF≤22%时无相关性（P=0.657）。对于RVEF >； 22%，建立以下CMR模型预测mPAP: 32.454 + (42.616 × VMI) - （19.276 × IVS曲率）。建立了另一个预测PVR的CMR模型：8.664 + (28.495 × VMI) - (0.053 × RVESVI) - （7.206 × RV SV/ESV）。验证表明与RHC有良好的相关性（mPAP: r=0.679; PVR: r=0.625，均P≤0.001）。Bland-Altman分析证实了CMR和RHC之间的一致性。结论scmr为评估CTD-PAH患者的mPAP和PVR提供了一种无创方法，在肺血流动力学评估中具有潜在的应用价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.