Non-invasive methods for estimating mPAP in COPD using cardiovascular magnetic resonance imaging

Area of Science:

• Cardiology
• Pulmonology
• Medical Imaging

Background:

• Pulmonary hypertension (PH) significantly worsens outcomes in patients with chronic obstructive pulmonary disease (COPD).
• Current diagnosis of PH requires invasive procedures like right heart catheterization (RHC).
• Non-invasive diagnostic tools are needed to assess PH in COPD patients.

Purpose of the Study:

• To evaluate the diagnostic accuracy of non-invasive cardiovascular magnetic resonance (CMR) models for PH in COPD.
• To assess the prognostic value of these CMR models in predicting survival in COPD patients with PH.

Main Methods:

• Retrospective analysis of COPD patients who underwent both CMR and RHC.
• Assessment of three CMR models: CMR-RV, CMR-PA/RV, and the Alpha index.
• Comparison of diagnostic performance and correlation with survival data.

Main Results:

• The CMR-PA/RV model demonstrated high diagnostic accuracy (AUC 0.93) for PH in COPD.
• CMR-RV and CMR-PA/RV models showed significant differences in survival based on RHC-mPAP thresholds.
• Right ventricular (RV) mass and pulmonary artery (PA) relative area change independently predicted mortality.

Conclusions:

• CMR offers valuable non-invasive diagnostic and prognostic information for PH in COPD.
• The CMR-PA/RV model is effective for diagnosing PH.
• RV mass index and PA relative area change are key prognostic indicators in PH-COPD.