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Pressure–volume relationship by pharmacological stress cardiovascular magnetic resonance

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Abstract

The variation between rest and peak stress end-systolic pressure–volume relation (ΔESPVR) is an index of myocardial contractility, easily obtained during routine stress echocardiography and never tested during dipyridamole stress-cardiac magnetic resonance (CMR). We assessed the ΔESPVR index in patients with known/suspected coronary artery disease (CAD) who underwent dipyridamole stress-CMR. One-hundred consecutive patients (24 females, 63.76 ± 10.17 years) were considered. ESPVR index was evaluated at rest and stress from raw measurement of systolic arterial pressure and end-systolic volume by biplane Simpson’s method. The ΔESPVR index showed a good inter-operator reproducibility. Mean ΔESPVR index was 0.48 ± 1.45 mmHg/mL/m2. ΔESPVR index was significantly lower in males than in females. ΔESPVR index was not correlated to rest left ventricular end-diastolic volume index or ejection fraction. Forty-six of 85 patients had myocardial fibrosis detected by the late gadolinium enhancement technique and they showed significantly lower ΔESPVR values. An abnormal stress CMR was found in 25 patients and they showed significantly lower ΔESPVR values. During a mean follow-up of 56.34 ± 30.04 months, 24 cardiovascular events occurred. At receiver-operating characteristic curve analysis, a ΔESPVR < 0.02 mmHg/mL/m2 predicted the presence of future cardiac events with a sensitivity of 0.79 and a specificity of 0.68. The noninvasive assessment of the ΔESPVR index during a dipyridamole stress-CMR exam is feasible and reproducible. The ΔESPVR index was independent from rest LV dimensions and function and can be used for a comparative assessment of patients with different diseases. ΔESPVR index by CMR can be a useful and simple marker for additional prognostic stratification.

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Data availability

The datasets analysed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank Claudia Santarlasci for skillful secretarial work and all patients for their cooperation.

Funding

No funding was received.

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Authors and Affiliations

  1. Magnetic Resonance Imaging Unit, Fondazione G. Monasterio CNR-Regione Toscana, Via Moruzzi, 1, 56124, Pisa, Italy

    Antonella Meloni & Alessia Pepe

  2. Cardiovascular Department, Azienda Sanitaria Universitaria di Trieste, Trieste, Italy

    Antonio De Luca & Chiara Cappelletto

  3. Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy

    Antonio De Luca, Chiara Cappelletto & Gianfranco Sinagra

  4. Division of Cardiology, University Hospital “P. Giaccone”, University of Palermo, Palermo, Italy

    Cinzia Nugara, Giuseppina Novo & Gianfranco Sinagra

  5. IRCSS Centro Neurolesi Bonino Pulejo, Messina, Italy

    Cinzia Nugara

  6. Division of Cardiology, Policlinico Vittorio Emanuele Hospital, University of Catania, Catania, Italy

    Maria Vaccaro & Valeria Calvi

  7. Cardiovascular Department, University Campus Bio-Medico, Roma, Italy

    Camilla Cavallaro & Francesco Grigioni

  8. Division of Cardiology and Cardiovascular Medicine, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy

    Andrea Barison, Giancarlo Todiere, Chrysanthos Grigoratos & Michele Emdin

  9. Institute of Life Sciences, Scuola Superiore Sant’Anna, Pisa, Italy

    Michele Emdin

  10. Department of Medicine, Institute of Radiology, University of Padua, Padua, Italy

    Alessia Pepe

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  1. Antonella Meloni
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  3. Cinzia Nugara
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Correspondence to Alessia Pepe.

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All patients gave written informed consent at the time of the CMR.

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Our study complies with the Declaration of Helsinki and was approved by the local ethics committee.

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Meloni, A., De Luca, A., Nugara, C. et al. Pressure–volume relationship by pharmacological stress cardiovascular magnetic resonance. Int J Cardiovasc Imaging 38, 853–861 (2022). https://doi.org/10.1007/s10554-021-02464-0

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