Energy efficiency and pulmonary artery flow after balloon pulmonary angioplasty for inoperable, chronic thromboembolic pulmonary hypertension: Analysis by phase-contrast MRI

Michinobu Nagao, Yuzo Yamasaki, Kotaro Abe, Kazuya Hosokawa, Satoshi Kawanami, Takeshi Kamitani, Torahiko Yamanouchi, Hidetake Yabuuchi, Kenji Fukushima, Hiroshi Honda

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Abstract

Purpose The aims of this study were to propose a new quantitative method for pulmonary artery (PA) flow energetics using phase-contrast magnetic resonance imaging (PC-MRI), and to investigate how balloon pulmonary angioplasty (BPA) impacts energetics in chronic thromboembolic pulmonary hypertension (CTEPH). Materials and methods PC-MRI at 3-Teslar and with a flow sensitive gradient echo was used to examine energetics prior to and following BPA for 24 CTEPH patients. Stroke volume (m; ml) and mean velocity (V; mm/s) for the main pulmonary artery (PA), right PA, and left PA were calculated from a time-flow curve derived from PC-MRI. Based on the Bernoulli principle, PA energy was identified as 1/2 mV2 (μj/kg), and energy loss was defined as the following equation “energy loss = main PA energy − (rt. PA energy + lt. PA energy)”. Results Right PA energy was significantly greater post-BPA than pre-BPA (61 ± 55 vs. 32 ± 40 μj/kg). There was no difference in main PA and left PA energies. Energy loss was significantly decreased post-BPA (18 ± 97 μj/kg) than pre-BPA (79 ± 125 μj/kg). An optimal cutoff of left PA energy of 45 μj/kg pre-BPA can be used to predict patients with mPAP ≥ 30 mmHg after BPA, with an area under the curve of 0.91, 78% sensitivity, and 92% specificity. Conclusion Analysis of PA energetics using phase-contrast MRI demonstrates that BPA improves energy loss in CTEPH. In addition, BPA responses can be predicted by PA energy status pre-treatment.

Original languageEnglish
Pages (from-to)99-104
Number of pages6
JournalEuropean Journal of Radiology
Volume87
DOIs
Publication statusPublished - Feb 1 2017

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Balloon Angioplasty
Pulmonary Hypertension
Pulmonary Artery
Lung
Magnetic Resonance Imaging
Stroke Volume
Area Under Curve

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

@article{64120d99881a4dd5bdce1e74ae565404,
title = "Energy efficiency and pulmonary artery flow after balloon pulmonary angioplasty for inoperable, chronic thromboembolic pulmonary hypertension: Analysis by phase-contrast MRI",
abstract = "Purpose The aims of this study were to propose a new quantitative method for pulmonary artery (PA) flow energetics using phase-contrast magnetic resonance imaging (PC-MRI), and to investigate how balloon pulmonary angioplasty (BPA) impacts energetics in chronic thromboembolic pulmonary hypertension (CTEPH). Materials and methods PC-MRI at 3-Teslar and with a flow sensitive gradient echo was used to examine energetics prior to and following BPA for 24 CTEPH patients. Stroke volume (m; ml) and mean velocity (V; mm/s) for the main pulmonary artery (PA), right PA, and left PA were calculated from a time-flow curve derived from PC-MRI. Based on the Bernoulli principle, PA energy was identified as 1/2 mV2 (μj/kg), and energy loss was defined as the following equation “energy loss = main PA energy − (rt. PA energy + lt. PA energy)”. Results Right PA energy was significantly greater post-BPA than pre-BPA (61 ± 55 vs. 32 ± 40 μj/kg). There was no difference in main PA and left PA energies. Energy loss was significantly decreased post-BPA (18 ± 97 μj/kg) than pre-BPA (79 ± 125 μj/kg). An optimal cutoff of left PA energy of 45 μj/kg pre-BPA can be used to predict patients with mPAP ≥ 30 mmHg after BPA, with an area under the curve of 0.91, 78{\%} sensitivity, and 92{\%} specificity. Conclusion Analysis of PA energetics using phase-contrast MRI demonstrates that BPA improves energy loss in CTEPH. In addition, BPA responses can be predicted by PA energy status pre-treatment.",
author = "Michinobu Nagao and Yuzo Yamasaki and Kotaro Abe and Kazuya Hosokawa and Satoshi Kawanami and Takeshi Kamitani and Torahiko Yamanouchi and Hidetake Yabuuchi and Kenji Fukushima and Hiroshi Honda",
year = "2017",
month = "2",
day = "1",
doi = "10.1016/j.ejrad.2016.12.015",
language = "English",
volume = "87",
pages = "99--104",
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publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Energy efficiency and pulmonary artery flow after balloon pulmonary angioplasty for inoperable, chronic thromboembolic pulmonary hypertension

T2 - Analysis by phase-contrast MRI

AU - Nagao, Michinobu

AU - Yamasaki, Yuzo

AU - Abe, Kotaro

AU - Hosokawa, Kazuya

AU - Kawanami, Satoshi

AU - Kamitani, Takeshi

AU - Yamanouchi, Torahiko

AU - Yabuuchi, Hidetake

AU - Fukushima, Kenji

AU - Honda, Hiroshi

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Purpose The aims of this study were to propose a new quantitative method for pulmonary artery (PA) flow energetics using phase-contrast magnetic resonance imaging (PC-MRI), and to investigate how balloon pulmonary angioplasty (BPA) impacts energetics in chronic thromboembolic pulmonary hypertension (CTEPH). Materials and methods PC-MRI at 3-Teslar and with a flow sensitive gradient echo was used to examine energetics prior to and following BPA for 24 CTEPH patients. Stroke volume (m; ml) and mean velocity (V; mm/s) for the main pulmonary artery (PA), right PA, and left PA were calculated from a time-flow curve derived from PC-MRI. Based on the Bernoulli principle, PA energy was identified as 1/2 mV2 (μj/kg), and energy loss was defined as the following equation “energy loss = main PA energy − (rt. PA energy + lt. PA energy)”. Results Right PA energy was significantly greater post-BPA than pre-BPA (61 ± 55 vs. 32 ± 40 μj/kg). There was no difference in main PA and left PA energies. Energy loss was significantly decreased post-BPA (18 ± 97 μj/kg) than pre-BPA (79 ± 125 μj/kg). An optimal cutoff of left PA energy of 45 μj/kg pre-BPA can be used to predict patients with mPAP ≥ 30 mmHg after BPA, with an area under the curve of 0.91, 78% sensitivity, and 92% specificity. Conclusion Analysis of PA energetics using phase-contrast MRI demonstrates that BPA improves energy loss in CTEPH. In addition, BPA responses can be predicted by PA energy status pre-treatment.

AB - Purpose The aims of this study were to propose a new quantitative method for pulmonary artery (PA) flow energetics using phase-contrast magnetic resonance imaging (PC-MRI), and to investigate how balloon pulmonary angioplasty (BPA) impacts energetics in chronic thromboembolic pulmonary hypertension (CTEPH). Materials and methods PC-MRI at 3-Teslar and with a flow sensitive gradient echo was used to examine energetics prior to and following BPA for 24 CTEPH patients. Stroke volume (m; ml) and mean velocity (V; mm/s) for the main pulmonary artery (PA), right PA, and left PA were calculated from a time-flow curve derived from PC-MRI. Based on the Bernoulli principle, PA energy was identified as 1/2 mV2 (μj/kg), and energy loss was defined as the following equation “energy loss = main PA energy − (rt. PA energy + lt. PA energy)”. Results Right PA energy was significantly greater post-BPA than pre-BPA (61 ± 55 vs. 32 ± 40 μj/kg). There was no difference in main PA and left PA energies. Energy loss was significantly decreased post-BPA (18 ± 97 μj/kg) than pre-BPA (79 ± 125 μj/kg). An optimal cutoff of left PA energy of 45 μj/kg pre-BPA can be used to predict patients with mPAP ≥ 30 mmHg after BPA, with an area under the curve of 0.91, 78% sensitivity, and 92% specificity. Conclusion Analysis of PA energetics using phase-contrast MRI demonstrates that BPA improves energy loss in CTEPH. In addition, BPA responses can be predicted by PA energy status pre-treatment.

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U2 - 10.1016/j.ejrad.2016.12.015

DO - 10.1016/j.ejrad.2016.12.015

M3 - Article

C2 - 28065382

AN - SCOPUS:85007189846

VL - 87

SP - 99

EP - 104

JO - European Journal of Radiology

JF - European Journal of Radiology

SN - 0720-048X

ER -