HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) AVI movie All Versions of this Article: 2343040151v1 234/3/710    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Roeleveld, R. J. Articles by Vonk-Noordegraaf, A. Search for Related Content PubMed PubMed Citation Articles by Roeleveld, R. J. Articles by Vonk-Noordegraaf, A.

Interventricular Septal Configuration at MR Imaging and Pulmonary Arterial Pressure in Pulmonary Hypertension¹

¹ From the Departments of Pulmonology (R.J.R., T.J.G., A.B., P.E.P., A.V.N.) and Physics and Medical Technology (J.T.M., T.J.C.F.), VU University Medical Center/Institute of Cardiovascular Research ICaR-VU, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands. Received January 26, 2004; revision requested April 6; revision received June 6; accepted September 22. Address correspondence to A.V.N. (e-mail: a.vonk@vumc.nl).

PURPOSE: To investigate whether a relationship exists between septum shape and systolic pulmonary arterial pressure (PAP) in patients with pulmonary hypertension.

MATERIALS AND METHODS: Study protocol was approved by institutional ethics review committee; all patients gave informed consent. Right-sided heart catheterization with vasodilator testing was performed in 39 adult subjects suspected of having pulmonary hypertension. There were 11 men and 28 women, aged 21–75 years (mean, 46 years). Only two patients showed favorable response to vasodilators, defined by a decrease in PAP of more than 20%. Synchronous right- and left-ventricular pressure measurements and four-chamber magnetic resonance (MR) imaging were used to identify timing of maximal leftward ventricular septal bowing within cardiac cycle. Septal bowing was evaluated with MR, measured on short-axis cine heart images, and expressed as curvature (reciprocal of radius). Curvature was quantified on one image (the one that showed the most severe distortion of normal septal shape). The relationship between systolic PAP and septal curvature was tested with linear regression analysis. P < .05 was considered to indicate a statistically significant difference.

RESULTS: Of 39 subjects, 37 had pulmonary hypertension. Maximal distortion of normal septal shape was found during right ventricular relaxation phase. Systolic PAP was proportional to septal curvature: r = 0.77 (P < .001), slope = –114.7, and intercept = 67.2. In the two vasodilator responsive subjects, a significant reduction of leftward ventricular septal bowing was observed in response to reduction of right ventricular pressure.

CONCLUSION: In 37 patients with pulmonary hypertension, systolic PAP higher than 67 mm Hg may be expected when leftward curvature is observed.

Supplemental material: radiology.rsnajnls.org/cgi/content/full/2343040151/DC1

© RSNA, 2005

This article has been cited by other articles:

				G. Reiter, U. Reiter, G. Kovacs, B. Kainz, K. Schmidt, R. Maier, H. Olschewski, and R. Rienmueller Magnetic Resonance-Derived 3-Dimensional Blood Flow Patterns in the Main Pulmonary Artery as a Marker of Pulmonary Hypertension and a Measure of Elevated Mean Pulmonary Arterial Pressure Circ Cardiovasc Imaging, July 1, 2008; 1(1): 23 - 30. [Abstract] [Full Text] [PDF]

				H. Rietema, S. Holverda, H. J. Bogaard, J. T. Marcus, H. J. Smit, N. Westerhof, P. E. Postmus, A. Boonstra, and A. Vonk-Noordegraaf Sildenafil treatment in COPD does not affect stroke volume or exercise capacity Eur. Respir. J., April 1, 2008; 31(4): 759 - 764. [Abstract] [Full Text] [PDF]

				J. T. Marcus, C. T.-J. Gan, J. J.M. Zwanenburg, A. Boonstra, C. P. Allaart, M. J.W. Gotte, and A. Vonk-Noordegraaf Interventricular Mechanical Asynchrony in Pulmonary Arterial Hypertension Left-to-Right Delay in Peak Shortening Is Related to Right Ventricular Overload and Left Ventricular Underfilling. J. Am. Coll. Cardiol., February 19, 2008; 51(7): 750 - 757. [Abstract] [Full Text] [PDF]

				J.G. Coghlan and J. Davar How should we assess right ventricular function in 2008? Eur. Heart J. Suppl., December 1, 2007; 9(suppl_H): H22 - H28. [Abstract] [Full Text] [PDF]

				A. Vonk-Noordegraaf, J.-W. Lankhaar, M. J.W. Gotte, J. T. Marcus, P. E. Postmus, and N. Westerhof Magnetic resonance and nuclear imaging of the right ventricle in pulmonary arterial hypertension Eur. Heart J. Suppl., December 1, 2007; 9(suppl_H): H29 - H34. [Abstract] [Full Text] [PDF]

				G.-P. Diller, K. Dimopoulos, H. Kafka, S. Y. Ho, and M. A. Gatzoulis Model of chronic adaptation: right ventricular function in Eisenmenger syndrome Eur. Heart J. Suppl., December 1, 2007; 9(suppl_H): H54 - H60. [Abstract] [Full Text] [PDF]

				I. M. Lang Management of acute and chronic RV dysfunction Eur. Heart J. Suppl., December 1, 2007; 9(suppl_H): H61 - H67. [Abstract] [Full Text] [PDF]

				H. J. Reesink, I. I. Tulevski, J. T. Marcus, F. Boomsma, J. J. Kloek, A. Vonk Noordegraaf, and P. Bresser Brain Natriuretic Peptide as Noninvasive Marker of the Severity of Right Ventricular Dysfunction in Chronic Thromboembolic Pulmonary Hypertension Ann. Thorac. Surg., August 1, 2007; 84(2): 537 - 543. [Abstract] [Full Text] [PDF]

				I. R. Henkens, K. T. B. Mouchaers, H. W. Vliegen, W. J. van der Laarse, C. A. Swenne, A. C. Maan, H. H. M. Draisma, I. Schalij, E. E. van der Wall, M. J. Schalij, et al. Early changes in rat hearts with developing pulmonary arterial hypertension can be detected with three-dimensional electrocardiography Am J Physiol Heart Circ Physiol, August 1, 2007; 293(2): H1300 - H1307. [Abstract] [Full Text] [PDF]

				S. A. van Wolferen, J. T. Marcus, A. Boonstra, K. M.J. Marques, J. G.F. Bronzwaer, M. D. Spreeuwenberg, P. E. Postmus, and A. Vonk-Noordegraaf Prognostic value of right ventricular mass, volume, and function in idiopathic pulmonary arterial hypertension Eur. Heart J., May 2, 2007; 28(10): 1250 - 1257. [Abstract] [Full Text] [PDF]

				K. Jorgensen, M. F. Muller, J. Nel, R. N. Upton, E. Houltz, and S.-E. Ricksten Reduced Intrathoracic Blood Volume and Left and Right Ventricular Dimensions in Patients With Severe Emphysema: An MRI Study Chest, April 1, 2007; 131(4): 1050 - 1057. [Abstract] [Full Text] [PDF]

				S. Dellegrottaglie, J. Sanz, M. Poon, J. F. Viles-Gonzalez, R. Sulica, M. Goyenechea, F. Macaluso, V. Fuster, and S. Rajagopalan Pulmonary Hypertension: Accuracy of Detection with Left Ventricular Septal-to-Free Wall Curvature Ratio Measured at Cardiac MR Radiology, April 1, 2007; 243(1): 63 - 69. [Abstract] [Full Text] [PDF]

				H. J. Reesink, J. T. Marcus, I. I. Tulevski, S. Jamieson, J. J. Kloek, A. V. Noordegraaf, and P. Bresser Reverse right ventricular remodeling after pulmonary endarterectomy in patients with chronic thromboembolic pulmonary hypertension: Utility of magnetic resonance imaging to demonstrate restoration of the right ventricle J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 58 - 64. [Abstract] [Full Text] [PDF]

				S. Holverda, C. T.-J. Gan, J. T. Marcus, P. E. Postmus, A. Boonstra, and A. Vonk-Noordegraaf Impaired Stroke Volume Response to Exercise in Pulmonary Arterial Hypertension J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1732 - 1733. [Full Text] [PDF]

				C. Tji-Joong Gan, J.-W. Lankhaar, J. T. Marcus, N. Westerhof, K. M. Marques, J. G. F. Bronzwaer, A. Boonstra, P. E. Postmus, and A. Vonk-Noordegraaf Impaired left ventricular filling due to right-to-left ventricular interaction in patients with pulmonary arterial hypertension Am J Physiol Heart Circ Physiol, April 1, 2006; 290(4): H1528 - H1533. [Abstract] [Full Text] [PDF]