Rapid Fire Abstracts
Anders Nelsson, MD
MD, PhD Student
Lund University and Skåne University Hospital, Lund, Sweden, Sweden
Per M Arvidsson, MD, PhD
Postdoctoral researcher
Lund University, Sweden
Per M Arvidsson, MD, PhD
Postdoctoral researcher
Lund University, Sweden
Martin Magnusson, MD, PhD
Professor
Lund University, Skåne University Hospital, Sweden
J. Gustav Smith, MD, PhD
Professor, medical doctor
The Wallenberg Laboratory/Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University and the Department of Cardiology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden, Sweden
Peter Kellman, PhD
Director of the Medical Signal and Image Processing Program
National Heart, Lung, and Blood Institute, National Institutes of Health
Marcus Carlsson, MD, PhD
Professor
Lund University and Skåne University Hospital, Lund, Sweden, Sweden
Ellen Ostenfeld, MD, PhD
MD, PhD, Associate professor
Lund University and Skåne University Hospital, Lund, Sweden, Sweden
Katarina Steding-Ehrenborg, PhD
RPT, PhD
Lund University and Skåne University Hospital, Lund, Sweden, Sweden
Håkan Arheden, MD, PhD
MD, PhD, Professor
Lund University and Skåne University Hospital, Lund, Sweden, Sweden
Pulmonary blood volume (PBV) estimates from cardiovascular magnetic resonance is a novel imaging marker of congestion, and carries prognostic information in heart failure patients.1 Here we aimed to determine whether PBV is correlated with more established markers of heart failure severity: LVEF, left atrial volume (LAV), and NT-proBNP.
Methods:
49 patients with heart failure (age 67+11 years, 29 females) underwent CMR at 1.5T using routine clinical sequences for a perfusion scan. PBV was calculated as the product of cardiac output and pulmonary transit time. Cardiac output was acquired from 2D aortic flow, and pulmonary transit time as the transit time for the contrast bolus from the right ventricle to the left ventricle using a prototype quantitative myocardial perfusion mapping sequence (Figure 1).2 The PBV was adjusted for the mean left atrial volume to only measure the blood volume in the pulmonary circulation and indexed to the body surface area.3 LVEF and LAV were measured from short-axis cine images. NT-proBNP was defined elevated if >283 pg/ml and LAVI increased if >56 ml/m2 for males and >53 ml/m2 for females. Correlations were performed using Pearson or Spearman correlations, and comparisons between groups using Student t-test or Mann-Whitney U according to normal distributions.
Results:
We observed a negative correlation between PBV and LVEF (r = -0.47, p< 0.001, Figure 2) and a positive correlation between PBV and LAV (r=0.42, p=0.003, Figure 3). There was a borderline significant correlation (r=0.30, p=0.052) between PBV and NT-pro BNP. When dichotomizing patients into normal or elevated NT-pro BNP there was no significant difference in PBV (p=0.12). However, PBV was significantly higher in patients with increased LAVI (p=0.002) than with normal LAVI, despite adjusting PBV for LA volumes.
Conclusion: Pulmonary blood volume derived from a clinical perfusion CMR scan correlates with other known markers of heart failure. Pulmonary blood volume may add value as a novel marker of severity in heart failure.
