Pulmonary hypertension: Accuracy of detection with left ventricular septal-to-free wall curvature ratio measured at cardiac MR

Santo Dellegrottaglie, Javier Sanz, Michael Poon, Juan Viles Gonzalez, Roxana Sulica, Martin Goyenechea, Frank Macaluso, Valentin Fuster, Sanjay Rajagopalan

Research output: Contribution to journalArticle

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Abstract

Purpose: To retrospectively evaluate the accuracy and reproducibility of the cardiac magnetic resonance (MR) imaging-derived left ventricular septal-to-free wall curvature ratio for prediction of the right ventricular systolic pressure (RVSP) in patients clinically known to have or suspected of having pulmonary hypertension (PH), with same-day right-side heart catheterization (RHC) as the reference standard. Materials and Methods: Institutional review board approval was received for this HIPAA-compliant study. Sixty-one patients clinically known or suspected of having PH underwent cardiac MR and RHC on the same day. Interventricular septal curvature (CIVS) and left ventricular free wall curvature (CFW) measured at end systole were used to derive the curvature ratio (CIVS/C FW). Effective distending transmural pressure (dPFW) and transseptal pressure gradient (dPIVS) were assumed to be equivalent, respectively, to the systolic blood pressure (SBP) and the difference between SBP and RVSP. Curvature ratio and SBP were used to noninvasively estimate RVSP. Linear regression analysis was performed to assess the difference between curvature ratio and rate of pressure rise (dP) ratio (dPIVS/dP FW). The accuracy of the dichotomized curvature ratio in PH detection was analyzed by using receiver operating characteristic (ROC) curves. Results: PH, defined as RVSP higher than 40 mmn Hg, was confirmed with RHC in 46 patients. A direct linear correlation between dP ratio and curvature ratio was observed (r = 0.85, P < .001). Bland-Altman analysis revealed moderate agreement between cardiac MR- and RHC-derived RVSPs (mean difference, -1.1 mm Hg ± 15.9 [standard deviation]). ROC analysis of the accuracy of the curvature ratio for detection of increased RVSP revealed 87% sensitivity and 100% specificity (area under ROC curve, 0.95; P < .001). Intraobserver (r = 0.97) and interobserver (r = 0.95) curvature ratio measurements were closely correlated. Conclusion: In patients clinically known to have or suspected of having PH, cardiac MR-derived curvature ratio, as compared with RHC measurement, was an accurate and reproducible index for estimation of RVSP.

Original languageEnglish
Pages (from-to)63-69
Number of pages7
JournalRadiology
Volume243
Issue number1
DOIs
StatePublished - Apr 1 2007
Externally publishedYes

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Pulmonary Hypertension
Magnetic Resonance Spectroscopy
Blood Pressure
Ventricular Pressure
Cardiac Catheterization
ROC Curve
Pressure
Health Insurance Portability and Accountability Act
Systole
Research Ethics Committees
Linear Models
Regression Analysis
Magnetic Resonance Imaging
Sensitivity and Specificity

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Dellegrottaglie, S., Sanz, J., Poon, M., Viles Gonzalez, J., Sulica, R., Goyenechea, M., ... Rajagopalan, S. (2007). Pulmonary hypertension: Accuracy of detection with left ventricular septal-to-free wall curvature ratio measured at cardiac MR. Radiology, 243(1), 63-69. https://doi.org/10.1148/radiol.2431060067

Pulmonary hypertension : Accuracy of detection with left ventricular septal-to-free wall curvature ratio measured at cardiac MR. / Dellegrottaglie, Santo; Sanz, Javier; Poon, Michael; Viles Gonzalez, Juan; Sulica, Roxana; Goyenechea, Martin; Macaluso, Frank; Fuster, Valentin; Rajagopalan, Sanjay.

In: Radiology, Vol. 243, No. 1, 01.04.2007, p. 63-69.

Research output: Contribution to journalArticle

Dellegrottaglie, S, Sanz, J, Poon, M, Viles Gonzalez, J, Sulica, R, Goyenechea, M, Macaluso, F, Fuster, V & Rajagopalan, S 2007, 'Pulmonary hypertension: Accuracy of detection with left ventricular septal-to-free wall curvature ratio measured at cardiac MR', Radiology, vol. 243, no. 1, pp. 63-69. https://doi.org/10.1148/radiol.2431060067
Dellegrottaglie, Santo ; Sanz, Javier ; Poon, Michael ; Viles Gonzalez, Juan ; Sulica, Roxana ; Goyenechea, Martin ; Macaluso, Frank ; Fuster, Valentin ; Rajagopalan, Sanjay. / Pulmonary hypertension : Accuracy of detection with left ventricular septal-to-free wall curvature ratio measured at cardiac MR. In: Radiology. 2007 ; Vol. 243, No. 1. pp. 63-69.
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abstract = "Purpose: To retrospectively evaluate the accuracy and reproducibility of the cardiac magnetic resonance (MR) imaging-derived left ventricular septal-to-free wall curvature ratio for prediction of the right ventricular systolic pressure (RVSP) in patients clinically known to have or suspected of having pulmonary hypertension (PH), with same-day right-side heart catheterization (RHC) as the reference standard. Materials and Methods: Institutional review board approval was received for this HIPAA-compliant study. Sixty-one patients clinically known or suspected of having PH underwent cardiac MR and RHC on the same day. Interventricular septal curvature (CIVS) and left ventricular free wall curvature (CFW) measured at end systole were used to derive the curvature ratio (CIVS/C FW). Effective distending transmural pressure (dPFW) and transseptal pressure gradient (dPIVS) were assumed to be equivalent, respectively, to the systolic blood pressure (SBP) and the difference between SBP and RVSP. Curvature ratio and SBP were used to noninvasively estimate RVSP. Linear regression analysis was performed to assess the difference between curvature ratio and rate of pressure rise (dP) ratio (dPIVS/dP FW). The accuracy of the dichotomized curvature ratio in PH detection was analyzed by using receiver operating characteristic (ROC) curves. Results: PH, defined as RVSP higher than 40 mmn Hg, was confirmed with RHC in 46 patients. A direct linear correlation between dP ratio and curvature ratio was observed (r = 0.85, P < .001). Bland-Altman analysis revealed moderate agreement between cardiac MR- and RHC-derived RVSPs (mean difference, -1.1 mm Hg ± 15.9 [standard deviation]). ROC analysis of the accuracy of the curvature ratio for detection of increased RVSP revealed 87{\%} sensitivity and 100{\%} specificity (area under ROC curve, 0.95; P < .001). Intraobserver (r = 0.97) and interobserver (r = 0.95) curvature ratio measurements were closely correlated. Conclusion: In patients clinically known to have or suspected of having PH, cardiac MR-derived curvature ratio, as compared with RHC measurement, was an accurate and reproducible index for estimation of RVSP.",
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AU - Sanz, Javier

AU - Poon, Michael

AU - Viles Gonzalez, Juan

AU - Sulica, Roxana

AU - Goyenechea, Martin

AU - Macaluso, Frank

AU - Fuster, Valentin

AU - Rajagopalan, Sanjay

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N2 - Purpose: To retrospectively evaluate the accuracy and reproducibility of the cardiac magnetic resonance (MR) imaging-derived left ventricular septal-to-free wall curvature ratio for prediction of the right ventricular systolic pressure (RVSP) in patients clinically known to have or suspected of having pulmonary hypertension (PH), with same-day right-side heart catheterization (RHC) as the reference standard. Materials and Methods: Institutional review board approval was received for this HIPAA-compliant study. Sixty-one patients clinically known or suspected of having PH underwent cardiac MR and RHC on the same day. Interventricular septal curvature (CIVS) and left ventricular free wall curvature (CFW) measured at end systole were used to derive the curvature ratio (CIVS/C FW). Effective distending transmural pressure (dPFW) and transseptal pressure gradient (dPIVS) were assumed to be equivalent, respectively, to the systolic blood pressure (SBP) and the difference between SBP and RVSP. Curvature ratio and SBP were used to noninvasively estimate RVSP. Linear regression analysis was performed to assess the difference between curvature ratio and rate of pressure rise (dP) ratio (dPIVS/dP FW). The accuracy of the dichotomized curvature ratio in PH detection was analyzed by using receiver operating characteristic (ROC) curves. Results: PH, defined as RVSP higher than 40 mmn Hg, was confirmed with RHC in 46 patients. A direct linear correlation between dP ratio and curvature ratio was observed (r = 0.85, P < .001). Bland-Altman analysis revealed moderate agreement between cardiac MR- and RHC-derived RVSPs (mean difference, -1.1 mm Hg ± 15.9 [standard deviation]). ROC analysis of the accuracy of the curvature ratio for detection of increased RVSP revealed 87% sensitivity and 100% specificity (area under ROC curve, 0.95; P < .001). Intraobserver (r = 0.97) and interobserver (r = 0.95) curvature ratio measurements were closely correlated. Conclusion: In patients clinically known to have or suspected of having PH, cardiac MR-derived curvature ratio, as compared with RHC measurement, was an accurate and reproducible index for estimation of RVSP.

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