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© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Cardiac magnetic resonance (CMR) is currently the gold standard for evaluating right ventricular (RV) function, which is critical in patients with pulmonary hypertension. CMR feature-tracking (FT) strain analysis has emerged as a technique to detect subtle changes. However, the dependence of RV strain on load is still a matter of debate. The aim of this study was to measure the afterload dependence of RV strain and to correlate it with surrogate markers of contractility in a cohort of patients with chronic thromboembolic pulmonary hypertension (CTEPH) under two different loading conditions before and after pulmonary endarterectomy (PEA). Between 2009 and 2022, 496 patients with 601 CMR examinations were retrospectively identified from our CTEPH cohort, and the results of 194 examinations with right heart catheterization within 24 h were available. The CMR FT strain (longitudinal (GLS) and circumferential (GCS)) was computed on steady-state free precession (SSFP) cine CMR sequences. The effective pulmonary arterial elastance (Ea) and RV chamber elastance (Ees) were approximated by dividing mean pulmonary arterial pressure by the indexed stroke volume or end-systolic volume, respectively. GLS and GCS correlated significantly with Ea and Ees/Ea in the overall cohort and individually before and after PEA. There was no general correlation with Ees; however, under high afterload, before PEA, Ees correlated significantly. The results show that RV GLS and GCS are highly afterload-dependent and reflect ventriculoarterial coupling. Ees was significantly correlated with strain only under high loading conditions, which probably reflects contractile adaptation to pulsatile load rather than contractility in general.

Details

Title
Right Ventricular Strain by Magnetic Resonance Feature Tracking Is Largely Afterload-Dependent and Does Not Reflect Contractility: Validation by Combined Volumetry and Invasive Pressure Tracings
Author
Rolf, Andreas 1   VIAFID ORCID Logo  ; Keller, Till 1   VIAFID ORCID Logo  ; Wolter, Jan Sebastian 2 ; Kriechbaum, Steffen 2 ; Weferling, Maren 3 ; Guth, Stefan 4   VIAFID ORCID Logo  ; Wiedenroth, Christoph 4 ; Mayer, Eckhard 4 ; Hamm, Christian W 1 ; Fischer-Rasokat, Ulrich 3 ; Treiber, Julia 3 

 Kerckhoff Heart and Thorax Center, Department of Cardiology, Benekestr. 2-8, 61231 Bad Nauheim, Germany; Medical Clinic I, Department of Cardiology, University of Giessen, 35390 Giessen, Germany; German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, 61231 Bad Nauheim, Germany 
 Kerckhoff Heart and Thorax Center, Department of Cardiology, Benekestr. 2-8, 61231 Bad Nauheim, Germany; German Center for Cardiovascular Research (DZHK), Partner Site RheinMain, 61231 Bad Nauheim, Germany 
 Kerckhoff Heart and Thorax Center, Department of Cardiology, Benekestr. 2-8, 61231 Bad Nauheim, Germany 
 Kerckhoff Heart and Thorax Center, Department of Thoracic Surgery, 61231 Bad Nauheim, Germany 
First page
3183
Publication year
2022
Publication date
2022
Publisher
MDPI AG
e-ISSN
20754418
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2756682011
Copyright
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.