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Assessment of right ventricle function and pulmonary artery circulation by cine-MRI in patients with AIDS
E Casalino1, J P Laissy, P Soyer
1Infectious Disease Intensive Care Unit, Bichat-Claude Bernard University Hospital, Paris, France.
Objective:
To evaluate right ventricle (RV) anatomy and performance and its relationships with pulmonary circulation in AIDS patients.
Design:
We conducted a prospective blinded study by using cine-MRI, a well-accepted method to assess RV and pulmonary circulation.
Setting:
A university hospital.
Participants:
Ten healthy volunteers and 13 asymptomatic AIDS patients.
Measurements:
RV end-diastolic and end-systolic volumes, RV ejection fraction (RVEF), pulmonary artery (PA) diameter, main pulmonary artery distensibility (MPAD), RV free wall diastolic thickness (RVWT), and RV mass were measured. The RVWT/left ventricular wall thickness index was calculated.
Results:
AIDS patients had significantly increased RV end-diastolic and end-systolic volumes and decreased RVEF (50 +/- 10 vs 59 +/- 6; p < 0.03). Four AIDS patients had RV wall motion abnormalities; 5 (38%) had an RVEF under 45%. RVWT, the RVWT/left ventricular wall thickness index, and PA diameter were significantly increased in AIDS patients. RV mass was increased in 54% of AIDS patients. MPAD was significantly lower in AIDS patients (18.8 +/- 15 vs 26 +/- 4; p < 0.01). A significant relationship was found between RV mass and MPAD (r = 0.76; p = 0.02).
Conclusions:
RV function is frequently impaired in AIDS patients. Anatomic and functional abnormalities found in RV and PA parameters suggest a systolic overload on RV. Pulmonary circulation abnormalities may influence RV structure and function in AIDS patients.