Document Detail


Magnetic resonance imaging guided catheterisation for assessment of pulmonary vascular resistance: in vivo validation and clinical application in patients with pulmonary hypertension.
MedLine Citation:
PMID:  16020598     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To validate in vivo a magnetic resonance imaging (MRI) method for measurement of pulmonary vascular resistance (PVR) and subsequently to apply this technique to patients with pulmonary hypertension (PHT). METHODS AND RESULTS: PVR was assessed from velocity encoded cine MRI derived pulmonary artery (PA) flow volumes and simultaneously determined invasive PA pressures. For pressure measurements flow directed catheters were guided under magnetic resonance fluoroscopy at 1.5 T into the PA. In preliminary validation studies (eight swine) PVR was determined with the thermodilution technique and compared with PVR obtained by MRI (0.9 (0.5) v 1.1 (0.3) Wood units.m2, p = 0.7). Bland-Altman test showed agreement between both methods. Inter-examination variability was high for thermodilution (6.2 (2.2)%) but low for MRI measurements (2.1 (0.3)%). After validation, the MRI method was applied in 10 patients with PHT and five controls. In patients with PHT PVR was measured at baseline and during inhalation of nitric oxide. Compared with the control group, PVR was significantly increased in the PHT group (1.2 (0.8) v 13.1 (5.6) Wood units.m2, p < 0.001) but decreased significantly to 10.3 (4.6) Wood units.m2 during inhalation of nitric oxide (p < 0.05). Inter-examination variability of MRI derived PVR measurements was 2.6 (0.6)%. In all experiments (in vivo and clinical) flow directed catheters were guided successfully into the PA under MRI control. CONCLUSIONS: Guidance of flow directed catheters into the PA is feasible under MRI control. PVR can be determined with high measurement precision with the proposed MRI technique, which is a promising tool to assess PVR in the clinical setting.
Authors:
T Kuehne; S Yilmaz; I Schulze-Neick; E Wellnhofer; P Ewert; E Nagel; P Lange
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  91     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-07-15     Completed Date:  2005-08-22     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1064-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Congenital Heart Diseases and Paediatric Cardiology, German Heart Institute, Berlin, Germany. kuehne@dhzb.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Animals
Blood Flow Velocity / physiology
Blood Pressure / physiology
Heart Catheterization / methods*
Humans
Hypertension, Pulmonary / physiopathology*
Magnetic Resonance Imaging, Cine / standards*
Nitric Oxide / pharmacology
Swine
Vascular Resistance / physiology*
Chemical
Reg. No./Substance:
10102-43-9/Nitric Oxide
Comments/Corrections
Comment In:
Heart. 2005 Aug;91(8):995-6   [PMID:  16020579 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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