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Pulmonary flow assessment by phase-contrast MRI can predict short-term mortality of fibrosing interstitial lung
Nanae Tsuchiya1, Tae Iwasawa2, Takashi Ogura3
1Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan.
Background:
Phase-contrast magnetic resonance imaging (PC-MRI) can determine pulmonary hemodynamics non-invasively. Pulmonary hypertension causes changes in pulmonary hemodynamics and is a factor for acute exacerbation and death in interstitial lung diseases (ILD).
Purpose:
To determine associations between pulmonary hemodynamics measured by PC-MRI and short-term mortality in patients with ILD.
Material And Methods:
Pulmonary hemodynamics, measured by PC-MRI in 43 patients with ILD, were reviewed retrospectively. Evaluation parameters included heart rate, right cardiac output, average flow, average velocity, acceleration time, acceleration volume (AV), maximal change in flow rate during ejection (M), M/AV, maximum area, minimum area, and relative area change in the pulmonary artery (PA). All causes of death within one year from the day of the MRI examination were assessed by reviewing medical records. Associations between evaluation parameters and outcome were determined by univariate and multivariate Cox regression analysis.
Results:
Six patients (13.9%) died by the one-year follow-up. Age (hazard ratio [HR] 1.116, 95% confidence interval [CI] 1.015-1.269), average flow (HR 0.932, 95% CI 0.870-0.984), average velocity (HR 0.778, 95% CI 0.573-0.976), right cardiac output (HR 0.870, 95% CI 0.758-0.967), AV (HR 0.840, 95% CI 0.669-0.985), M/AV (HR 1.008, 95% CI 1.001-1.014), and PA relative area change (HR 0.715, 95% CI 0.459-0.928) predicted death in univariate Cox analysis. Multivariate Cox analysis showed decreased right cardiac output (HR 0.547, 95% CI 0.160-0.912) and decreased PA relative area change (HR 0.538, 95% CI 0.177-0.922) were independently associated with death.
Conclusion:
Reduction in right cardiac output and decreased PA relative area change, detected by PC-MRI, were associated with increased mortality in ILD.
Insights
Reduced right cardiac output and pulmonary artery relative area change, measured by phase-contrast MRI, are linked to higher mortality in interstitial lung disease patients. These hemodynamic markers predict short-term survival in ILD.
Area of Science:
- Cardiovascular Imaging
- Pulmonary Medicine
- Medical Diagnostics
Background:
- Phase-contrast magnetic resonance imaging (PC-MRI) offers non-invasive assessment of pulmonary hemodynamics.
- Pulmonary hypertension, indicated by altered hemodynamics, is a significant risk factor for mortality in interstitial lung diseases (ILD).
Purpose of the Study:
- To investigate the association between pulmonary hemodynamics evaluated by PC-MRI and short-term mortality in patients diagnosed with ILD.
Main Methods:
- Retrospective review of PC-MRI data from 43 ILD patients, analyzing parameters like right cardiac output and pulmonary artery (PA) relative area change.
- Univariate and multivariate Cox regression analyses were employed to determine associations between hemodynamic parameters and one-year mortality.
Main Results:
- Decreased right cardiac output and reduced PA relative area change were independently associated with increased mortality in ILD patients.
- Several hemodynamic parameters, including average flow, average velocity, and acceleration volume, showed univariate associations with death.
Conclusions:
- PC-MRI detected reductions in right cardiac output and PA relative area change are significant predictors of mortality in ILD.
- These hemodynamic findings highlight potential targets for risk stratification and management in ILD.
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