Dataset Information

Right heart imaging in patients with heart failure: a tale of two ventricles.

ABSTRACT: The purpose is to describe the recent advances made in imaging of the right heart, including deformation imaging, tissue, and flow characterization by MRI, and molecular imaging.Recent developments have been made in the field of deformation imaging of the right heart, which may improve risk stratification of patients with heart failure and pulmonary hypertension. In addition, more attention has been given to load adaptability metrics of the right heart; these simplified indices, however, still face challenges from a conceptual point of view. The emergence of novel MRI sequences, such as native T1 mapping, allows better detection and quantification of myocardial fibrosis and could allow better prediction of postsurgical recovery of the right heart. Other advances in MRI include four-dimensional flow imaging, which may be particularly useful in congenital heart disease or for the detection of early stages of pulmonary vascular disease.The review will place the recent developments in right heart imaging in the context of clinical care and research.

SUBMITTER: Amsallem M

PROVIDER: S-EPMC5133417 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

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Right heart imaging in patients with heart failure: a tale of two ventricles.

Amsallem Myriam M Kuznetsova Tatiana T Hanneman Kate K Denault Andre A Haddad François F

Current opinion in cardiology 20160901 5

<h4>Purpose of review</h4>The purpose is to describe the recent advances made in imaging of the right heart, including deformation imaging, tissue, and flow characterization by MRI, and molecular imaging.<h4>Recent findings</h4>Recent developments have been made in the field of deformation imaging of the right heart, which may improve risk stratification of patients with heart failure and pulmonary hypertension. In addition, more attention has been given to load adaptability metrics of the right ...[more]

PMID: 27467173

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Project description:ObjectivesUpright computed tomography (CT) can detect slight changes particularly in the superior vena cava (SVC) volume in healthy volunteers under the influence of gravity. This study aimed to evaluate whether upright CT-based measurements of the SVC area are useful for assessing mean right atrial pressure (mRAP) in patients with heart failure.MethodsWe performed CT in both standing and supine positions to evaluate the SVC (directly below the junction of the bilateral brachiocephalic veins) and inferior vena cava (IVC; at the height of the diaphragm) areas and analyzed their relationship with mRAP, measured by right heart catheterization in 23 patients with heart failure.ResultsThe median age of enrolled patients was 60 (51-72) years, and 69.6% were male. The median mRAP was 3 (1-7) mmHg. The correlations between the standing position SVC and IVC areas and mRAP were stronger than those in the supine position (SVC, ρ = 0.68, p < 0.001 and ρ = 0.43, p = 0.040; IVC, ρ = 0.57, p = 0.005 and ρ = 0.46, p = 0.026; respectively). Furthermore, the SVC area in the standing position was most accurate in identifying patients with higher mRAP (> 5 mmHg) (SVC standing, area under the receiver operating characteristic curve [AUC] = 0.91, 95% confidence interval [CI], 0.77-1.00; SVC supine, AUC = 0.78, 95% CI, 0.59-0.98; IVC standing, AUC = 0.77, 95% CI, 0.55-0.98; IVC supine, AUC = 0.72, 95% CI, 0.49-0.94). The inter- and intraobserver agreements (evaluated by intraclass correlation coefficients) for all CT measurements were 0.962-0.991.ConclusionsUpright CT-based measurement of the SVC area can be useful for non-invasive estimation of mRAP under the influence of gravity in patients with heart failure.Key points• This study showed that the superior vena cava (SVC) area in the standing position was most accurate in identifying patients with heart failure with higher mean right atrial pressure. • Upright computed tomography-based measurements of the SVC area can be a promising non-invasive method for estimating mean right atrial pressure under the influence of gravity in patients with heart failure. • Clinical management of patients with heart failure based on this non-invasive modality may lead to early assessment of conditional changes and reduced hospitalization for exacerbation of heart failure.

Dataset Information

Right heart imaging in patients with heart failure: a tale of two ventricles.

Publications

Right heart imaging in patients with heart failure: a tale of two ventricles.

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