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The role of 1.5T cardiac MRI in the diagnosis, prognosis and management of pulmonary arterial hypertension

  • Gianluca MarroneEmail author
  • Giuseppe Mamone
  • Angelo Luca
  • Patrizio Vitulo
  • Alessandro Bertani
  • Michele Pilato
  • Bruno Gridelli
Review

Abstract

Cardiovascular magnetic imaging is a noninvasive, three dimensional tomographic technique that allows for a detailed morphology of the cardiac chambers, the accurate quantification of right ventricle volumes, myocardial mass, and transvalvular flow. It can also determine whether right ventricular diastolic function is impaired through pulmonary hypertension. The aim of this article is to review the main kinetic, morphological and functional changes of the right ventricle that can occur in patients affected by pulmonary arterial hypertension (PAH) and to assess how the MRI findings can influence the prognosis, and guide the decision-making strategy. In those cases in which MRI shows a significant cardiac diastolic dysfunction, the prognosis is predictive of pharmacological treatment failure, and mortality. This leaves double lung-heart transplantation as the only therapeutic option. The coexistence of PAH and left ventricle impairment causes worse right ventricle function, leads to a poor prognosis, and may change the therapeutic strategies (for example, PAH associated with left ventricle dysfunction may require a double lung-heart transplant).

Keywords

Pulmonary arterial hypertension Cardiac magnetic resonance Dysfunction of the right ventricle Chronic thromboembolic pulmonary hypertension MR angiography Delayed enhancement 

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Copyright information

© Springer Science+Business Media, B.V. 2010

Authors and Affiliations

  • Gianluca Marrone
    • 1
    Email author
  • Giuseppe Mamone
    • 1
  • Angelo Luca
    • 1
  • Patrizio Vitulo
    • 2
  • Alessandro Bertani
    • 3
  • Michele Pilato
    • 4
  • Bruno Gridelli
    • 5
  1. 1.Diagnostic and Interventional Radiology, Mediterranean Institute of Transplantation and High Specialization Therapy (ISMETT)PalermoItaly
  2. 2.Pneumology, Mediterranean Institute of Transplantation and High Specialization Therapy (ISMETT)PalermoItaly
  3. 3.Thoracic Surgery, Mediterranean Institute of Transplantation and High Specialization Therapy (ISMETT)PalermoItaly
  4. 4.Cardiac Surgery, Mediterranean Institute of Transplantation and High Specialization Therapy (ISMETT)PalermoItaly
  5. 5.Abdominal and Thoracic Surgery, Mediterranean Institute of Transplantation and High Specialization Therapy (ISMETT)PalermoItaly

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