M Agustina Sciancalepore

University of Chicago, Chicago, IL, United States

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Publications (2)2.15 Total impact

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    ABSTRACT: Although abnormal septal motion is a well-known sign of increased pulmonary arterial pressures, it is not routinely used to quantify the severity of pulmonary hypertension (PH). This determination relies on invasive measurements or Doppler echocardiographic estimation of right ventricular (RV) pressures, which is not always feasible or accurate in patients with PH. We hypothesized that dynamic 3D analysis of septal curvature from cardiac magnetic resonance (CMR) images may reveal differences between patients with different degrees of PH. Forty-four patients (14 controls; 30 PH patients who underwent right heart catheterization) were studied using CMR and echocardiography. CMR imaging was performed using Philips 1.5T scanner with a phased-array cardiac coil, in a retrospectively gated steady-state free precession cine mode at 30 frames per cardiac cycle. Patients were divided into 3 subgroups according to pulmonary arterial pressure. CMR images were used to reconstruct dynamic 3D left ventricular endocardial surfaces, which were analyzed to calculate septal curvature throughout the cardiac cycle. 3D curvature analysis was feasible in 88% patients. Septal curvature showed different temporal patterns in different groups. Curvature values progressively decreased with increasing severity of PH, and correlated well with invasive pressures (r-values 0.78-0.79), pulmonary vascular resistance (r = 0.83) and Doppler-derived RV peak-systolic pressure (r = 0.75). 3D analysis of septal curvature from CMR images may become a useful component in the CMR examination in patients with known or suspected PH.
    The international journal of cardiovascular imaging 06/2011; 28(5):1073-85. · 2.15 Impact Factor
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    ABSTRACT: Although abnormal motion of the interventricular septum (IVS) caused by elevated right ventricular pressure in patients with pulmonary hypertension (PH) is easy to recognize visually, determination of the severity of PH relies on measurements of pulmonary arterial pressure (PAP). We hypothesized that quantitative 3D analysis of regional IVS curvature throughout the cardiac cycle could be used to differentiate patients with different degrees of PH. Cardiac magnetic resonance (CMR) images (Philips 1.5T) were obtained in 14 normal subjects and 30 patients with PH undergoing right heart catheterization, who were divided into 3 subgroups according to mean PAP. Images were used to reconstruct dynamic 3D LV endocardial surfaces, which were analyzed to calculate 3D IVS curvature throughout the cardiac cycle. In normal subjects, IVS curvature was positive, reflecting the convex septal shape and showed little change throughout the cardiac cycle. In patients with PH, IVS curvature was lower, reflecting septal flattening, and fluctuated throughout the cardiac cycle, reflecting the abnormal “bouncing” septal motion. In patients with severe PH, IVS curvature reached negative values, reflecting transient concave septal shape. Dynamic 3D analysis of IVS curvature from CMR images may provide an alternative for noninvasive assessment of severity of PH.
    Computing in Cardiology, 2010; 10/2010