Evidence map›Paper›PMID 40350364›Full record

ArticleAcademic radiology2025

Semi-quantitative Analysis of Right Ventricular Myocardial First-pass Perfusion Using Cardiac Magnetic Resonance Imaging in Systemic Sclerosis and Pulmonary Arterial Hypertension.

Ali Borhani, Iman Yazdani Nia, Ghazal Zandieh, Stephen C Mathai, Steven Hsu, Paul M Hassoun, Ihab R Kamel, Stefan L Zimmerman, Bharath Ambale Venkatesh

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Article in Academic radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Ali BorhaniThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287 (A.B., G.Z., I.R.K., S.L.Z., B.A.V.).
Iman Yazdani NiaDepartment of Radiology, University of Pennsylvania, Pennsylvania, Philadelphia (I.Y.N.).
Ghazal ZandiehThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287 (A.B., G.Z., I.R.K., S.L.Z., B.A.V.).
Stephen C MathaiDivision of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287 (S.C.M., P.M.H.).
Steven HsuDivisions of Cardiology, Johns Hopkins University, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287 (S.H.).
Paul M HassounDivision of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287 (S.C.M., P.M.H.).
Ihab R KamelThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287 (A.B., G.Z., I.R.K., S.L.Z., B.A.V.).
Stefan L ZimmermanThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287 (A.B., G.Z., I.R.K., S.L.Z., B.A.V.).
Bharath Ambale VenkateshThe Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD 21287 (A.B., G.Z., I.R.K., S.L.Z., B.A.V.). Electronic address: bambale1@jhmi.edu.

Funding

Mechanisms of Right Ventricular Dysfunction in Scleroderma-associated PAHR01HL114910 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI HASSOUN, PAUL M. · 2012 to 2023
$6.2M
Mechanisms and treatment of right ventricular sarcomere dysfunction in scleroderma-associated pulmonary arterial hypertensionK23HL146889 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI HSU, STEVEN · 2019 to 2023
$886k
NHLBI NIH HHS K23 HL146889NHLBI NIH HHS R01 HL114910
6 · The paper itself

Abstract

backgroundRight ventricular (RV) myocardial perfusion has been touted as a primary mechanism to understand impairment in RV function in patients with pulmonary arterial hypertension (PAH). However, measuring RV perfusion presents technical challenges. In this study, our aim is to employ a semi-quantitative approach using cardiac magnetic resonance (CMR) imaging to measure RV free wall first-pass perfusion in patients with PAH and controls, and to evaluate the intra- and inter-reader reproducibility of this approach.

methodsThis study included 37 subjects (mean age 58.2±12 years, 72.9% female), 8 with idiopathic pulmonary arterial hypertension (IPAH), 10 with systemic sclerosis (SSc) and pulmonary arterial hypertension (PAH), 12 with SSc without PAH, and seven healthy controls. All participants underwent rest and adenosine stress perfusion CMR imaging using a 3 T scanner as part of a research protocol for evaluating pulmonary hypertension. Two readers delineated three regions of interest (ROIs) within the visible RV myocardium and manually traced contours of endocardial and epicardial borders of the left ventricle (LV) in two planes. Semi-quantitative perfusion analysis was performed with dedicated software for the measurement of first-pass myocardial perfusion. Concordance correlation coefficients (CCC) assessed inter- and intra-reader agreement of measurements.

resultsPatients had an RV Ejection fraction (EF) of 50.9±11.3% and LVEF of 63.8±6.4 % and controls had an RVEF of 61.3±6.7 % and LVEF of 65.5±5.1 %. RV myocardial perfusion measurements at rest and stress were similar between the two readers (2.29±1.17 (mL/g × min) and 2.77±1.44 (mL/g × min) at rest, 4.02±2.45 (mL/g × min) and 4.35±2.72 (mL/g × min) during stress. The agreement was best for stress phase (0.90), followed by rest phase (0.83), and myocardial perfusion reserve index (MPRI) (0.72). The agreement was higher between readers for LV perfusion measurements (rest phase: 0.97, stress phase: 0.99, and MPRI: 0.89). RV MPRI was significantly higher in controls (2.62±0.73) as compared to all patients (1.63±0.75). The differences remained when controls were compared to patients with PAH.

conclusionSemi-quantitative first-pass RV perfusion reserve measures are technically feasible and show excellent inter-reader agreement. RV perfusion reserve index was lower in patients with PAH compared to healthy controls.

Indexed as

Hypertension, PulmonaryMagnetic Resonance ImagingMyocardial Perfusion ImagingScleroderma, SystemicVentricular Dysfunction, RightFemaleHumansMaleMiddle AgedPulmonary Arterial HypertensionReproducibility of ResultsCardiac magnetic resonance imagingMyocardial perfusionRight ventricleSemi-quantitative analysis

Identifiers

PMID40350364
PMCPMC12279449

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.