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Pulmonary vasculature
Assessment of proximal pulmonary arterial stiffness using magnetic resonance imaging: effects of technique, age and exercise
  1. Jonathan R Weir-McCall1,
  2. Anu Kamalasanan2,
  3. Deidre B Cassidy1,
  4. Allan D Struthers1,
  5. Brian J Lipworth3 and
  6. J Graeme Houston1
  1. 1Division of Cardiovascular and Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, UK
  2. 2Department of Clinical Radiology, Ninewells Hospital and Medical School, Dundee, UK
  3. 3Scottish Centre for Respiratory Research, Medical Research Institute, University of Dundee, Dundee, UK
  1. Correspondence to Professor J Graeme Houston; ghouston{at}nhs.net

Abstract

Introduction To compare the reproducibility of pulmonary pulse wave velocity (PWV) techniques, and the effects of age and exercise on these.

Methods 10 young healthy volunteers (YHV) and 20 older healthy volunteers (OHV) with no cardiac or lung condition were recruited. High temporal resolution phase contrast sequences were performed through the main pulmonary arteries (MPAs), right pulmonary arteries (RPAs) and left pulmonary arteries (LPAs), while high spatial resolution sequences were obtained through the MPA. YHV underwent 2 MRIs 6 months apart with the sequences repeated during exercise. OHV underwent an MRI scan with on-table repetition. PWV was calculated using the transit time (TT) and flow area techniques (QA). 3 methods for calculating QA PWV were compared.

Results PWV did not differ between the two age groups (YHV 2.4±0.3/ms, OHV 2.9±0.2/ms, p=0.1). Using a high temporal resolution sequence through the RPA using the QA accounting for wave reflections yielded consistently better within-scan, interscan, intraobserver and interobserver reproducibility. Exercise did not result in a change in either TT PWV (mean (95% CI) of the differences: −0.42 (−1.2 to 0.4), p=0.24) or QA PWV (mean (95% CI) of the differences: 0.10 (−0.5 to 0.9), p=0.49) despite a significant rise in heart rate (65±2 to 87±3, p<0.0001), blood pressure (113/68 to 130/84, p<0.0001) and cardiac output (5.4±0.4 to 6.7±0.6 L/min, p=0.004).

Conclusions QA PWV performed through the RPA using a high temporal resolution sequence accounting for wave reflections yields the most reproducible measurements of pulmonary PWV.

  • Imaging/CT MRI etc

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bmjresp-2016-000149

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    Footnotes

    • Contributors JRW-M recruited the volunteers, acquired the images, made the measurements, analysed them, drafted the paper and prepared the tables and figures. DBC, AK, ADS, BJL and JGH participated in the design of the study, helped in statistical analysis, preparation of tables and figures, and worked on the text of the paper. All authors read and approved the final manuscript.

    • Funding The present study was funded by the Wellcome Trust through the Scottish Translational Medicine and Therapeutics Initiative (grant number WT 085664) in the form of a Clinical Research Fellowship.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Ethics approval This study was reviewed and approved by the East of Scotland Research Ethics Committee.

    • Data sharing statement No additional data are available.