Right Ventricular Function in Takayasu's Arteritis Patients With Pulmonary Artery Involvement Using MRI Feature Tracking

Qing Li; Hua Liao; Yue Ren; Dan Yang; Qingping Yun; Zhiyan Wang; Zhen Zhou; Shuang Li; Jianxiu Lian; Hui Wang; Lijun Zhang; Zhonghua Sun; Lili Pan; Lei Xu

doi:10.1002/jmri.29143

Right Ventricular Function in Takayasu's Arteritis Patients With Pulmonary Artery Involvement Using MRI Feature Tracking

J Magn Reson Imaging. 2023 Dec 1. doi: 10.1002/jmri.29143. Online ahead of print.

Authors

Qing Li¹, Hua Liao², Yue Ren¹, Dan Yang³, Qingping Yun⁴, Zhiyan Wang⁵, Zhen Zhou¹, Shuang Li¹, Jianxiu Lian⁶, Hui Wang¹, Lijun Zhang¹, Zhonghua Sun⁷, Lili Pan², Lei Xu¹

Affiliations

¹ Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
² Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
³ Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁴ Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.
⁵ Department of Cardiovascular Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
⁶ Clinical & Technical Support, Philips Healthcare, Beijing, China.
⁷ Discipline of Medical Radiation Science, Curtin Medical School, Curtin University, Perth, Western Australia, Australia.

PMID: 38038356
DOI: 10.1002/jmri.29143

Abstract

Background: Pulmonary artery involvement (PAI) is not rare in Takayasu arteritis (TA). Persistently elevated pulmonary arterial pressure in TA-PAI patients leads to pulmonary hypertension (PH), and eventually cardiac death. Thus, the early detection of right ventricular dysfunction before the onset of PH is important.

Purpose: To explore the potential of right ventricular global peak longitudinal and circumferential strain (RVGLS and RVGCS, respectively) in detecting right ventricular myocardial damage in TA-PAI patients without PH.

Study type: Retrospective.

Population: One hundred and six TA patients (39.6 ± 13.9 years), of whom 52 were non-PAI and 54 were PAI patients (36 without PH and 18 with PH), along with 58 sex- and age-matched healthy volunteers (HVs) (36.7 ± 13.2 years). The involved arteries were validated by aorta magnetic resonance (MR) angiography and pulmonary artery computed tomography angiography.

Field strength/sequence: 3 T/Cine imaging sequence with a steady-state free precession readout.

Assessment: Cardiac MRI-derived parameters measured by two radiologists independently were compared among HVs, and TA patients with and without PAI. In addition, these indices were further compared among HVs, and TA-PAI patients with and without PH.

Statistical tests: Student's t test, one-way ANOVA analysis, Pearson and Spearman correlation analysis, and reproducibility analysis. A P-value of <0.05 was considered statistically significant.

Results: Although the TA-PAI patients without PH had a similar RV ejection fraction (RVEF) with HV (P = 0.348), RVGLS (non-PH 20.6 ± 3.7% vs. HV 24.0 ± 3.1%) was significantly lower and RVGCS (non-PH 14.8 ± 3.9% vs. HV 13.0 ± 2.7%) higher. The TA-PAI patients with PH had significantly poorer RVGLS (PH 13.5 ± 3.8% vs. non-PH 20.6 ± 3.7%) and RVGCS (PH 10.9 ± 3.2% vs. non-PH 14.8 ± 3.9%) than those without PH.

Data conclusion: Right ventricular dysfunction was detected in the TA-PAI patients without PH. MR-feature tracking may be an effective method for detecting early cardiac damage in the TA-PAI patients without PH.

Level of evidence: 3 TECHNICAL EFFICACY: Stage 3.

Keywords: Takayasu's arteritis; cardiac MRI; pulmonary hypertension.

Abstract

Grants and funding