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Paradoxical Interventricular Septal Motion as a Major Determinant of Late Gadolinium Enhancement in Ventricular Insertion Points in Pulmonary Hypertension

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Title: Paradoxical Interventricular Septal Motion as a Major Determinant of Late Gadolinium Enhancement in Ventricular Insertion Points in Pulmonary Hypertension
Authors: Sato, Takahiro Browse this author
Tsujino, Ichizo Browse this author →KAKEN DB
Ohira, Hiroshi Browse this author
Oyama-Manabe, Noriko Browse this author →KAKEN DB
Ito, Yoichi M. Browse this author
Noguchi, Teruo Browse this author
Yamada, Asuka Browse this author
Ikeda, Daisuke Browse this author
Watanabe, Taku Browse this author
Nishimura, Masaharu Browse this author →KAKEN DB
Issue Date: 24-Jun-2013
Publisher: Public Library of Science
Journal Title: Plos One
Volume: 8
Issue: 6
Start Page: e66724
Publisher DOI: 10.1371/journal.pone.0066724
PMID: 23826118
Abstract: Background: This study investigated the major clinical determinants of late gadolinium enhancement (LGE) at ventricular insertion points (VIPs) commonly seen in patients with pulmonary hypertension (PH). Methods: Forty-six consecutive PH patients (mean pulmonary artery pressure >= 25 mmHg at rest) and 21 matched controls were examined. Right ventricular (RV) morphology, function and LGE mass volume at VIPs were assessed by cardiac magnetic resonance (CMR). Radial motion of the left ventricular (LV) wall and interventricular septum (IVS) was assessed by speckle-tracking echocardiography. Paradoxical IVS motion index was then calculated. Univariate and multivariate regression analysis were conducted to characterize the relationship between LGE volume at VIPs and PH-related clinical indices, including the paradoxical IVS motion index. Results: Mean pulmonary arterial pressure (MPAP) of PH patients was 3869 mmHg. LGE at VIPs was observed in 42 of 46 PH patients, and the LGE volume was 2.02 mL (0.47-2.99 mL). Significant correlations with LGE volume at VIPs were observed for MPAP (r = 0.50) and CMR-derived parameters [RV mass index (r = 0.53), RV end-diastolic volume index (r = 0.53), RV ejection fraction (r = -0.56), and paradoxical IVS motion index (r = 0.77)]. In multiple regression analysis, paradoxical IVS motion index alone significantly predicted LGE volume at VIPs (p<0.001). Conclusions: LGE at VIPs seen in patients with PH appears to reflect altered IVS motion rather than elevated RV pressure or remodeling. Long-term studies would be of benefit to characterize the clinical relevance of LGE at VIPs.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 辻野 一三

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