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Pulmonary blood volume index as a quantitative biomarker of haemodynamic congestion in hypertrophic cardiomyopathy

Ricci, Fabrizio LU ; Aung, Nay ; Thomson, Ross ; Boubertakh, Redha ; Camaioni, Claudia ; Doimo, Sara ; Sanghvi, Mihir M. ; Fung, Kenneth ; Khanji, Mohammed Y. and Lee, Aaron , et al. (2019) In European Heart Journal Cardiovascular Imaging 20(12). p.1368-1376
Abstract

AIMS : The non-invasive assessment of left ventricular (LV) diastolic function and filling pressure in hypertrophic cardiomyopathy (HCM) is still an open issue. Pulmonary blood volume index (PBVI) by cardiovascular magnetic resonance (CMR) has been proposed as a quantitative biomarker of haemodynamic congestion. We aimed to assess the diagnostic accuracy of PBVI for left atrial pressure (LAP) estimation in patients with HCM. METHODS AND RESULTS : We retrospectively identified 69 consecutive HCM outpatients (age 58 ± 11 years; 83% men) who underwent both transthoracic echocardiography (TTE) and CMR. Guideline-based detection of LV diastolic dysfunction was assessed by TTE, blinded to CMR results. PBVI was calculated as the product of... (More)

AIMS : The non-invasive assessment of left ventricular (LV) diastolic function and filling pressure in hypertrophic cardiomyopathy (HCM) is still an open issue. Pulmonary blood volume index (PBVI) by cardiovascular magnetic resonance (CMR) has been proposed as a quantitative biomarker of haemodynamic congestion. We aimed to assess the diagnostic accuracy of PBVI for left atrial pressure (LAP) estimation in patients with HCM. METHODS AND RESULTS : We retrospectively identified 69 consecutive HCM outpatients (age 58 ± 11 years; 83% men) who underwent both transthoracic echocardiography (TTE) and CMR. Guideline-based detection of LV diastolic dysfunction was assessed by TTE, blinded to CMR results. PBVI was calculated as the product of right ventricular stroke volume index and the number of cardiac cycles for a bolus of gadolinium to pass through the pulmonary circulation as assessed by first-pass perfusion imaging. Compared to patients with normal LAP, patients with increased LAP showed significantly larger PBVI (463 ± 127 vs. 310 ± 86 mL/m2, P < 0.001). PBVI increased progressively with worsening New York Heart Association functional class and echocardiographic stages of diastolic dysfunction (P < 0.001 for both). At the best cut-off point of 413 mL/m2, PBVI yielded good diagnostic accuracy for the diagnosis of LV diastolic dysfunction with increased LAP [C-statistic = 0.83; 95% confidence interval (CI): 0.73-0.94]. At multivariable logistic regression analysis, PBVI was an independent predictor of increased LAP (odds ratio per 10% increase: 1.97, 95% CI: 1.06-3.68; P = 0.03). CONCLUSION : PBVI is a promising CMR application for assessment of diastolic function and LAP in patients with HCM and may serve as a quantitative marker for detection, grading, and monitoring of haemodynamic congestion.

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organization
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type
Contribution to journal
publication status
published
subject
keywords
cardiovascular magnetic resonance, diastolic dysfunction, echocardiography, hypertrophic cardiomyopathy, pulmonary blood volume
in
European Heart Journal Cardiovascular Imaging
volume
20
issue
12
pages
9 pages
publisher
Oxford University Press
external identifiers
  • scopus:85075813543
  • pmid:31504370
ISSN
2047-2412
DOI
10.1093/ehjci/jez213
language
English
LU publication?
yes
id
195d03af-73b7-46d7-9076-6f2a33150dec
date added to LUP
2019-12-13 00:18:51
date last changed
2024-06-26 08:05:12
@article{195d03af-73b7-46d7-9076-6f2a33150dec,
  abstract     = {{<p>AIMS : The non-invasive assessment of left ventricular (LV) diastolic function and filling pressure in hypertrophic cardiomyopathy (HCM) is still an open issue. Pulmonary blood volume index (PBVI) by cardiovascular magnetic resonance (CMR) has been proposed as a quantitative biomarker of haemodynamic congestion. We aimed to assess the diagnostic accuracy of PBVI for left atrial pressure (LAP) estimation in patients with HCM. METHODS AND RESULTS : We retrospectively identified 69 consecutive HCM outpatients (age 58 ± 11 years; 83% men) who underwent both transthoracic echocardiography (TTE) and CMR. Guideline-based detection of LV diastolic dysfunction was assessed by TTE, blinded to CMR results. PBVI was calculated as the product of right ventricular stroke volume index and the number of cardiac cycles for a bolus of gadolinium to pass through the pulmonary circulation as assessed by first-pass perfusion imaging. Compared to patients with normal LAP, patients with increased LAP showed significantly larger PBVI (463 ± 127 vs. 310 ± 86 mL/m2, P &lt; 0.001). PBVI increased progressively with worsening New York Heart Association functional class and echocardiographic stages of diastolic dysfunction (P &lt; 0.001 for both). At the best cut-off point of 413 mL/m2, PBVI yielded good diagnostic accuracy for the diagnosis of LV diastolic dysfunction with increased LAP [C-statistic = 0.83; 95% confidence interval (CI): 0.73-0.94]. At multivariable logistic regression analysis, PBVI was an independent predictor of increased LAP (odds ratio per 10% increase: 1.97, 95% CI: 1.06-3.68; P = 0.03). CONCLUSION : PBVI is a promising CMR application for assessment of diastolic function and LAP in patients with HCM and may serve as a quantitative marker for detection, grading, and monitoring of haemodynamic congestion.</p>}},
  author       = {{Ricci, Fabrizio and Aung, Nay and Thomson, Ross and Boubertakh, Redha and Camaioni, Claudia and Doimo, Sara and Sanghvi, Mihir M. and Fung, Kenneth and Khanji, Mohammed Y. and Lee, Aaron and Malcolmson, James and Mantini, Cesare and Paiva, José and Gallina, Sabina and Fedorowski, Artur and Mohiddin, Saidi A. and Aquaro, Giovanni Donato and Petersen, Steffen E.}},
  issn         = {{2047-2412}},
  keywords     = {{cardiovascular magnetic resonance; diastolic dysfunction; echocardiography; hypertrophic cardiomyopathy; pulmonary blood volume}},
  language     = {{eng}},
  month        = {{12}},
  number       = {{12}},
  pages        = {{1368--1376}},
  publisher    = {{Oxford University Press}},
  series       = {{European Heart Journal Cardiovascular Imaging}},
  title        = {{Pulmonary blood volume index as a quantitative biomarker of haemodynamic congestion in hypertrophic cardiomyopathy}},
  url          = {{http://dx.doi.org/10.1093/ehjci/jez213}},
  doi          = {{10.1093/ehjci/jez213}},
  volume       = {{20}},
  year         = {{2019}},
}