Altered Right Ventricular Kinetic Energy Work Density and Viscous Energy Dissipation in Patients with Pulmonary Arterial Hypertension: A Pilot Study Using 4D Flow MRI.
Altered Right Ventricular Kinetic Energy Work Density and Viscous Energy Dissipation in Patients with Pulmonary Arterial Hypertension: A Pilot Study Using 4D Flow MRI.
复制标题
肺动脉高压患者右心室动能功密度和粘性能量耗散的改变： 使用 4D 流量 MRI 的试点研究。
DOI：
10.1371/journal.pone.0138365
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Han Y
中科院分区：
文献类型：
--
作者：
Han QJ;Witschey WR;Fang-Yen CM;Arkles JS;Barker AJ;Forfia PR;Han Y
右心室（RV）功能越来越被认为是肺动脉高压（PAH）患者发病率和死亡率的重要预测因素。增加的RV后负荷增加了PAH中的RV功。我们使用时间分辨3D相位对比MRI（4D flow MRI）推导出肺动脉（PA）中的RV动能（KE）工作密度和能量损失，以更好地表征PAH患者的RV工作。在10例功能I/II级PAH患者和9例健康受试者中获得了4D血流和标准心脏电影图像。对于每个人，我们计算了RV KE工作密度和PA中的粘性耗散量。与健康受试者相比，PAH患者RV和PA的血流模式发生了改变。PAH受试者的RV KE工作密度显著高于健康受试者（94.7±33.7 mJ/mL vs. 61.7±14.8 mJ/mL，p = 0.007），并且在整个心动周期内PA能量损失百分比也更大（21.1±6.4% vs. 2.2± 1.3%，p = 0.0001）。RV KE工作密度和PA能量损失百分比与RV射血分数有轻度和中度相关性。本研究量化了两个动能指标，以使用4D血流评估RV功能。RV KE工作密度和PA粘性能量损失不仅区分了健康受试者和患者，还区分了PAH患者。这些指标有望作为RV功能的成像标记物。
Right ventricular (RV) function has increasingly being recognized as an important predictor for morbidity and mortality in patients with pulmonary arterial hypertension (PAH). The increased RV after-load increase RV work in PAH. We used time-resolved 3D phase contrast MRI (4D flow MRI) to derive RV kinetic energy (KE) work density and energy loss in the pulmonary artery (PA) to better characterize RV work in PAH patients. 4D flow and standard cardiac cine images were obtained in ten functional class I/II patients with PAH and nine healthy subjects. For each individual, we calculated the RV KE work density and the amount of viscous dissipation in the PA. PAH patients had alterations in flow patterns in both the RV and the PA compared to healthy subjects. PAH subjects had significantly higher RV KE work density than healthy subjects (94.7±33.7 mJ/mL vs. 61.7±14.8 mJ/mL, p = 0.007) as well as a much greater percent PA energy loss (21.1±6.4% vs. 2.2±1.3%, p = 0.0001) throughout the cardiac cycle. RV KE work density and percent PA energy loss had mild and moderate correlations with RV ejection fraction. This study has quantified two kinetic energy metrics to assess RV function using 4D flow. RV KE work density and PA viscous energy loss not only distinguished healthy subjects from patients, but also provided distinction amongst PAH patients. These metrics hold promise as imaging markers for RV function.