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Aims: To determine the presence and extent of delayed contrast enhancement(DCE) in patients with pulmonary hypertension(PHT) using contrast enhanced-cardiovascular magnetic resonance imaging(ce-CMR). Methods and results: Twenty-five patients with PHT underwent ce-CMR and right heart catheterization. Right ventricular(RV) and left ventricular(LV) volumes, ejection fraction, mass, and DCE mass were determined with ce-CMR. Mean pulmonary artery pressure(mean PAP) averaged 43(12) mmHg and cardiac output 4.3(1.2) L/min. DCE was demonstrated in 23 out of 25 patien ts. DCE was confined to the RV insertion points(RVIPs) in seven patients and extended into the interventricular septum(IVS) in the remaining 16 patients. In these 16 patients, septal contrast enhancement was associated with IVS bowing. The extent of contrast enhancement correlated positively with RV end-diastolic volu me/ body surface area, RV mass, mean PAP, and pulmonary vascular resistance and correlated inversely with RV ejection fraction. Conclusion: DCE was present with in the RVIPs and IVS of most patients with PHT studied. Extent of DCE correlated with RV function and pulmonary haemodynamics. DCE was associated with IVS bowin g and may provide a novel marker for occult septal abnormalities directly relati ng to the haemodynamic stress experienced by these patients.
Aims: To determine the presence and extent of delayed contrast enhancement (DCE) in patients with pulmonary hypertension (PHT) using contrast enhanced-cardiovascular magnetic resonance imaging (ce-CMR). Methods and results: Twenty-five patients with PHT underwent ce- CMR and right heart catheterization. Right ventricular (RV) and left ventricular (LV) volumes, ejection fraction, mass, and DCE mass were determined with ce-CMR. Mean pulmonary artery pressure (mean PAP) averaged 43 (12) mmHg and cardiac DCE was confined to the RV insertion points (RVIPs) in seven patients and extended into the interventricular septum (IVS) in the remaining 16 patients. In these 16 patients, septal contrast enhancement was associated with IVS bowing. The extent of contrast enhancement enhancement positively with RV end-diastolic volu me / body surface area, RV mass, mean PAP, and pulmonary vascular resistance and correlated inversely with RV ejecti on fraction. Conclusion: DCE was present with in the RVIPs and IVS of most patients with PHT studied. Extent of DCE correlated with RV function and pulmonary haemodynamics. DCE was associated with IVS bowin g and may provide a novel marker for occult septal abnormalities directly relati ng to the haemodynamic stress experienced by these patients.