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COMPARISON OF PULMONARY CIRCULATION PARAMETERS ACQUIRED BY CARDIOVASCULAR MAGNETIC RESONANCE WITH RIGHT HEART CATHETERIZATION AND ECHOCARDIOGRAPHY IN PATIENTS WITH RECENT-ONSET DILATED CARDIOMYOPATHY
Topic: Heart failure
Type: Presentation - doctors , Number in the programme: 69
Opatřil L.1, Panovský R.1, Mojica-Pisciotti M.2, Máchal J.3, Holeček T.4, Feitová V.4, Godava J.5, Poloczková H.5, Kincl V.1, Michael A.6, Krejčí J.7

1 I. interní kardioangiologická klinika, Mezinárodní centrum klinického výzkumu, FN U sv. Anny, Lékařská fakulta Masarykovy univerzity, Brno, 2 FN U sv. Anny, Mezinárodní centrum klinického výzkumu, Brno, 3 Ústav patologické fyziologie, Mezinárodní centrum klinického výzkumu, Lékařská fakulta Masarykovy univerzity, FN U sv. Anny, Brno, 4 Klinika zobrazovacích metod, Mezinárodní centrum klinického výzkumu, FN U sv. Anny, Brno, 5 I. interní kardioangiologická klinika FN U sv. Anny, Lékařská fakulta Masarykovy univerzity, Brno, 6 Mezinárodní centrum klinického výzkumu FN U sv. Anny, Lékařská fakulta Masarykovy univerzity, Brno, 7 I. interní kardioangiologická klinika, FN U sv. Anny, Lékařská fakulta Masarykovy univerzity


Aim
Pulmonary circulation parameters (PCP) are a relatively new technique with the potential for complex evaluation of the cardio-pulmonary system as a whole. Right heart catheterization (RHC) is the gold standard in evaluating pulmonary hypertension (PH) and hemodynamics.
Methodology
Eighty-four patients with recent-onset dilated cardiomyopathy (RODCM) were retrospectively included in this study. All patients had a CMR examination allowing for calculating the PCP - namely pulmonary transit time (PTT) and pulmonary transit beats (PTB), and ECHO and RHC. Patients were divided into groups according to the PH measured by RHC and the diastolic function measured by echocardiography.
PTT and PTB were correlated with ECHO and RHC markers and the ability of PTT to determine a presence of RHC-defined PH was expressed by the area under receiver operating characteristic (ROC) curve.
Results
According to ECHO, 17 patients had a normal diastolic function, 35 impaired relaxation, 13 pseudonormalization, and 19 restrictive filling pattern. From RHC, 47 had either post- or precapillary PH.
Both PTT and PTB correlated with LVEF, PCWP and cardiac index (all p<0.01).
In addition, only PTT correlated with pulmonary vascular resistance (p=0.015), and with much higher correlation coefficients with E/A (p=0.01), and E/e’ (p=0.03) as well. Patients with restrictive filling pattern showed significantly longer PTT (p=0.01; pFinally, the ROC curve for PTT and PH was assessed with an area under curve of 72.7% with a cut-off value of 8.62 s.
Conclusion
To our knowledge, this is the first study focused on CMR-derived PCP in a RODCM group, including all three diagnostic modalities as gold standards. Their comprehensive evaluation is very important and from our findings, PTT might offer non invasive option for such an evaluation.