regional and global Biventricular Function in Pulmonary arterial hypertension: A Cardiac MR Imaging Study 1

To determine whether chronic pulmonary arterial pressure (PAP) elevation affects regional biventricular function and whether regional myocardial function may be reduced in pulmonary arterial hypertension (PAH) patients with preserved global right ventricular (RV) function. After informed consent, 35 PAH patients were evaluated with right heart catheterization and cardiac magnetic resonance (MR) imaging and compared with 13 healthy control subjects. Biventricular segmental, section, and mean ventricular peak systolic longitudinal strain ( E LL ), as well as left ventricular (LV) circumferential and RV tangential strains were compared between PAH patients and control subjects and correlated with global function and catheterization of the right heart indexes. Spearman r correlation with Bonferroni correction was used. Multiple linear regression analysis was performed to determine predictors for regional myocardial function. In the RV of PAH patients, longitudinal contractility was reduced at the basal, mid, and apical levels, and tangential contractility was reduced at the midventricular level. Mean LL positively correlated with mean PAP ( 0.62, P , and pulmonary vascular resistance index basal anteroseptal longitudinal contractility. (c) PAH patients, compared with control subjects, with preserved RVEF show reduced regional RV longitudinal contractility at the anterior RV septal insertion sites.