Journal
JACC-CARDIOVASCULAR IMAGING
Volume 9, Issue 6, Pages 715-732Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jcmg.2015.12.015
Keywords
anatomy; computed tomography; magnetic resonance imaging; physiology; pulmonary hypertension; pulmonary vasculature; right ventricle
Funding
- International Society of Heart and Lung Transplantation
- Northwestern Memorial Foundation
- Radiological Society of North America Research and Education Foundation
- Society of Interventional Radiology Foundation
- Bard Access Systems
- National Institutes of Health [K25HL119608, R01 HL086939, R01 HL105598, R01 HL115828, R01 HL117888, R01 HL107557, R01 HL127028]
- United Therapeutics
- Actelion
- Novartis
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Imaging plays a central role in the diagnosis and management of all forms of pulmonary hypertension (PH). Although Doppler echocardiography is essential for the evaluation of PH, its ability to optimally evaluate the right ventricle and pulmonary vasculature is limited by its 2-dimensional planar capabilities. Magnetic resonance and computed tomography are capable of determining the etiology and pathophysiology of PH, and can be very useful in the management of these patients. Exciting new techniques such as right ventricle tissue characterization with T1 mapping, 4-dimensional flow of the right ventricle and pulmonary arteries, and computed tomography lung perfusion imaging are paving the way for a new era of imaging in PH. These imaging modalities complement echocardiography and invasive hemodynamic testing and may be useful as surrogate endpoints for early phase PH clinical trials. Here we discuss the role of magnetic resonance imaging and computed tomography in the diagnosis and management of PH, including current uses and novel research applications, and we discuss the role of value-based imaging in PH. (C) 2016 by the American College of Cardiology Foundation.
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