Abstract 3017: Reverse Right Ventricular Remodeling After Pulmonary Endarterectomy Assessed by MRI
Pulmonary hypertension causes right ventricular (RV) remodeling, i.e. RV dilatation, hypertrophy and left ventricular (LV) septum deviation. We studied the effect of pulmonary endarterectomy (PEA) on restoration of RV remodeling in chronic thromboembolic pulmonary hypertension (CTEPH). In 17 CTEPH patients, before and after PEA, and 12 age-matched healthy controls, ventricular end diastolic and systolic volumes (EDV/ESV, ml.m−2), mass (g.m−2) and septum deviation (1/radius, cm−1) were determined by magnetic resonance imaging (MRI, 1.5 T, Sonata, Siemens, Germany) using MASS software (MEDIS, the Netherlands). Before PEA, RV ESV, mass and septum deviation differed significantly between patients and healthy controls. LV mass was similar. Upon PEA, cardiac MRI parameters (Table 1⇓) and pulmonary hemodynamics improved significantly. The decrease (Δ) in RV mass correlated with Δ total pulmonary resistance (r=0.64, p<0.01). In conclusion, after PEA, RV volumes and the pathologic septum deviation normalized, RV hypertrophy near normalized. In CTEPH patients, MRI is a useful instrument to quantify RV remodeling and dysfunction and to study its restoration after PEA.