Non-invasive stroke volume assessment in patients with pulmonary arterial hypertension: left-sided data mandatory
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BioMed Central
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Non-invasive stroke volume assessment in patients with pulmonary arterial hypertension: left-sided data mandatory Gert-Jan Mauritz1, J Tim Marcus2, Anco Boonstra1, Pieter E Postmus1, Nico Westerhof1,3 and Anton Vonk-Noordegraaf*1 Address: 1Department of Pulmonary Diseases, Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, Amsterdam, The Netherlands, 2Department of Physics and Medical Technology, Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, Amsterdam, The Netherlands and 3Department of Physiology, Institute for Cardiovascular Research ICaR-VU, VU University Medical Center, Amsterdam, The Netherlands Email: Gert-Jan Mauritz - [email protected]; J Tim Marcus - [email protected]; Anco Boonstra - [email protected]; Pieter E Postmus - [email protected]; Nico Westerhof - [email protected]; Anton Vonk-Noordegraaf* - [email protected] * Corresponding author
Published: 5 November 2008 Journal of Cardiovascular Magnetic Resonance 2008, 10:51
doi:10.1186/1532-429X-10-51
Received: 18 August 2008 Accepted: 5 November 2008
This article is available from: http://www.jcmr-online.com/content/10/1/51 © 2008 Mauritz et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Cardiovascular Magnetic Resonance (CMR) is an emerging modality in the diagnosis and follow-up of patients with Pulmonary Arterial Hypertension (PAH). Derivation of stroke volume (SV) from the pulmonary flow curves is considered as a standard in this respect. Our aim was to investigate the accuracy of pulmonary artery (PA) flow for measuring SV. Methods: Thirty-four PAH patients underwent both CMR and right-sided heart catheterisation. CMR-derived SV was measured by PA flow, left (LV) and right ventricular (RV) volumes, and, in a subset of nine patients also by aortic flow. These SV values were compared to the SV obtained by invasive Fick method. Results: For SV by PA flow versus Fick, r = 0.71, mean difference was -4.2 ml with limits of agreement 26.8 and -18.3 ml. For SV by LV volumes versus Fick, r = 0.95, mean difference was -0.8 ml with limits of agreement of 8.7 and -10.4 ml. For SV by RV volumes versus Fick, r = 0.73, mean difference -0.75 ml with limits of agreement 21.8 and -23.3 ml. In the subset of nine patients, SV by aorta flow versus Fick yielded r = 0.95, while in this subset SV by pulmonary flow versus Fick yielded r = 0.76. For all regression analyses, p < 0.0001. Conclusion: In conclusion, SV from PA flow has limited accuracy in PAH patients. LV volumes and aorta flow are to be preferred for the measurement of SV.
Introduction In pulmonary arterial hypertension (PAH), cardiovascular magnetic resonance (CMR) has been proposed as a standard for the assessment of right ventricular
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