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Updated: Mar 17, 2026
Hemodynamic Characterization of Rodent Models of Pulmonary Arterial Hypertension
Published on: April 11, 2016
Characterization of CMR-derived haemodynamic data in children with pulmonary arterial hypertension
Michal Schäfer1,2, D Dunbar Ivy1, Alex J Barker3
1Department of Pediatrics, Section of Cardiology, Children's Hospital Colorado, Denver-Aurora, CO, USA.
Insights
Children with pulmonary arterial hypertension (PAH) show reduced wall shear stress and increased vascular stiffness. This impacts right ventricular (RV) function, highlighting key hemodynamic changes in paediatric PAH.
Area of Science:
- Cardiovascular Medicine
- Paediatric Cardiology
- Biomedical Engineering
Background:
- Paediatric pulmonary arterial hypertension (PAH) involves elevated arterial pressure and progressive stiffening.
- Understanding haemodynamic alterations and vascular stiffness is crucial for managing paediatric PAH.
Purpose of the Study:
- To characterize regional flow haemodynamic patterns and vascular stiffness markers in proximal pulmonary arteries of paediatric PAH patients.
- To investigate the association between these haemodynamic changes and right ventricular (RV) function.
Main Methods:
- Cardiac magnetic resonance imaging was used in 40 paediatric PAH patients and 26 controls.
- Computed metrics included wall shear stress (WSS), oscillatory shear index (OSI), and relative area change (RAC).
- Phase-contrast imaging assessed haemodynamics in the main and right pulmonary arteries (MPA and RPA).
Main Results:
- PAH patients exhibited significantly decreased systolic WSS and RAC in both MPA and RPA compared to controls.
- The oscillatory shear index (OSI) was elevated in the MPA of PAH subjects.
- MPA WSS positively correlated with RAC and RV ejection fraction, indicating a link between haemodynamics, stiffness, and RV function.
Conclusions:
- Wall shear stress is markedly reduced in paediatric PAH patients.
- This reduction correlates with increased stiffness in the proximal pulmonary arteries and impaired RV function.
Aims:
Paediatric pulmonary arterial hypertension (PAH) is manifested as increased arterial pressure and vascular resistive changes followed by progressive arterial stiffening. The aim of this study was to characterize regional flow haemodynamic patterns and markers of vascular stiffness in the proximal pulmonary arteries of paediatric PAH patients, and to explore the association with right ventricular (RV) function.
Methods And Results:
Forty paediatric PAH patients and 26 age- and size-matched controls underwent cardiac magnetic resonance studies in order to compute time-resolved wall shear stress metrics, oscillatory shear index (OSI), and vascular strain as measured by relative area change (RAC), and RV volumetric and functional parameters. Phase-contrast imaging planes were positioned perpendicular to the mid-main and right pulmonary arteries (MPA and RPA, respectively). Compared with controls, the PAH group had decreased systolic wall shear stress (dyne cm-2) and RAC (%) in both MPA (WSSsys: 6.5 vs. 4.3, P < 0.0001; RAC: 36 vs. 25, P < 0.0001) and RPA (WSSsys: 11.2 vs. 7.3, P < 0.0001; strain: 37 vs. 30, P < 0.05). The OSI was significantly higher in the MPA of PAH subjects (0.46 vs. 0.17, P < 0.05). WSS measured in the MPA correlated positively with RAC (r = 0.63, P < 0.0001) and RV ejection fraction (%) (r = 0.63, P < 0.0001).
Conclusion:
Wall shear stress, the principal haemodynamic force driving endothelial functional changes, is severely decreased in paediatric PAH patients and correlates with increased stiffness in the proximal pulmonary vasculature and reduced RV function.
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