Variable | Main advantages | Main disadvantages |
---|---|---|
RV and LV: EDVI/ESVI/SVI, myocardial mass | Routinely performed, reliable assessment of cardiac size, RVEDVI/LVEDVI/SVI and RV mass index predictors of mortality in adult PH, initial and follow-up study to study disease progression | Observer variance problems depending on standards/training |
EF | Routinely assessed parameter of global ventricular pump function, RVEF related to outcome in paediatric PH | Load-dependent parameter of RV function, may miss early systolic dysfunction |
Blood flow (PCMR) | Routinely performed, selective blood flow measurements in any vessel of appropriate size possible, estimation of pulmonary and systemic blood flow, quantification of shunt flow, low intrastudy and interstudy reproducibility | Time consuming if several vessels are examined, helical flow pattern in main PA, no accurate assessment of peak blood flow velocities (no reliable assessment of pressure gradients), susceptible to non-flow-related phase errors |
Late gadolinium enhancement (LGE) | Visualisation of macroscopic myocardial fibrosis | Contrast agent necessary, longer examination time, conflicting data regarding prognostic value of LGE in adults, no data in paediatric PH |
Strain, strain rate | Additional parameter of myocardial function, assessment of intraventricular and interventricular dyssynchrony, postprocessing analysis by tissue tracking software, easy to perform | Not routinely assessed, tagging techniques time consuming, myocardial feature tracking from cine-SSFP possible but no data available in paediatric PH for either technique |
Septal curvature | Valid estimation of sPAP and PVR in paediatric PH | Not routinely assessed, postprocessing time |
T1 mapping | Quantification of diffuse myocardial fibrosis | Only data in experimental model of chronic PH |
Pulmonary artery stiffness: pulsatility/capacitance/distensibility/compliance | Early marker of PH; independently associated with the degree of RV dysfunction, dilation, and hypertrophy in PH | Not routinely assessed, no data in paediatric PH |
RV–PA coupling | Easy to calculate, comprehensive analysis of ventricular contractility and vascular load, correlated with outcome in adult PH | Invasive data necessary, no data in paediatric PH |
CMR, cardiac MR; EDVI, indexed enddiastolic volume; ESVI, indexed endsystolic volume; LGE, late gadolinium enhancement; LV, left ventricle; LVEDVI, indexed left ventricular enddiastolic volume; PH, pulmonary hypertension; PCMR, phase-contrast MR; PVR, pulmonary vascular resistance; RV, right ventricular; RVEDVI, indexed right ventricular enddiastolic volume; RVEF, right ventricular ejection fraction; SSFP, steady-state free precession.