Elizabeth Haag

Jeannette McLaughlin

Jie J Cao

Joshua Cheng

Justine Lachmann

Michael Passick

Nathaniel Reichek

Yi Wang

Journal of Cardiovascular Magnetic Resonance

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BioMed Central
Journal of Cardiovascular Magnetic 
Resonance
ssOpen AccePoster presentation
Impaired lung perfusion in patients with congestive heart failure by 
quantitative MRI perfusion
Jie J Cao*, Yi Wang, Jeannette McLaughlin, Elizabeth Haag, Michael Passick, 
Joshua Cheng, Justine Lachmann and Nathaniel Reichek
Address: St Francis Hospital, Roslyn, NY, USA
* Corresponding author    
Introduction
Congestive heart failure (CHF) is associated with reduced
end-organ perfusion and can lead to organ failure. Clini-
cal assessment of organ perfusion has relied on measures
of organ function, an indirect strategy.
Purpose
We sought to assess lung perfusion quantitatively by MRI
in patients with CHF and to define factors associated with
impaired lung perfusion.
Methods
Study subjects were prospectively enrolled and underwent
cardiac MRI at 1.5 T. First-pass perfusion was performed
with 0.01 mmol/kg gadopentetate in 3 coronal slices cov-
ering anterior, mid and posterior lung fields during inspi-
ration using a saturation recovery SSFP sequence. Mean
signal intensity of all pixels in pulmonary parenchyma at
each time point was evaluated using a custom model-
independent deconvolution program for perfusion quan-
titation. Pulmonary transit time was measured as the time
interval between peak signal intensity in the main pulmo-
nary artery and peak signal intensity in the left atrium.
Cardiac function was assessed using SSFP standard short
axis cine imaging. Pulmonary flow was measured by
through plane phase contrast imaging in the main pulmo-
nary artery.
Results
Of the 25 subjects enrolled 7 were normal controls and 15
were patients with systolic CHF in I-III NYHA functional
class who completed lung perfusion imaging in inspira-
tion. Average lung perfusion was reduced in CHF patients,
81 ± 32 ml/100 ml/min vs 118 ± 48 ml/100 ml/min in
controls (p = 0.046). Similar to normal controls patients
with CHF maintained a perfusion gradient in the gravity
direction with the highest perfusion in posterior and the
lowest in anterior lung field. However, the absolute per-
fusion was reduced in all lung fields with anterior, mid
and posterior perfusion 58 ± 26, 85 ± 38, 106 ± 36 ml/100
ml/min in CHF patients and 73 ± 53, 116 ± 53, 165 ± 45
ml/100 ml/min in controls. Reduced lung perfusion was
associated with lower pulmonary flow (indexed by BSA)
(r = -0.771, p < 0.001), longer pulmonary transit time (r =
-0.729, p < 0.001), a marker of total pulmonary resistance,
lower LVEF (r = 0.443, p = 0.039) and lower RVEF (r = -
0.474, p = 0.026). In a multivariate regression analysis
including all variables associated with lung perfusion and
an interaction term for pulmonary flow and pulmonary
transit time since they were significantly correlated, the
predictors of lung perfusion were pulmonary flow and
flow/transit time interaction, suggesting the importance
of both forward flow and total pulmonary resistance.
Conclusion
Lung perfusion is decreased in patients with systolic CHF.
The reduced perfusion is associated with both impaired
from 13th Annual SCMR Scientific Sessions
Phoenix, AZ, USA. 21-24 January 2010
Published: 21 January 2010
Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P108 doi:10.1186/1532-429X-12-S1-P108
<supplement> <title> <p>Abstracts of the 13<sup>th </sup>Annual SCMR Scientific Sessions - 2010</p> </title> <note>Meeting abstracts - A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-full.pdf">here</a>.</note> <url>http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-info</url> </supplement>
This abstract is available from: http://jcmr-online.com/content/12/S1/P108
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forward flow and increased pulmonary vascular resist-
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Impaired lung perfusion in patients with congestive heart failure by quantitative MRI perfusion

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Impaired lung perfusion in patients with congestive heart failure by quantitative MRI perfusion

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