Abstract #3543

Right Ventricular Perfusion Reserve Predicts Response to Pulmonary Thromboendarterectomy

Lexiaozi Fan¹, Brandon C. Benefield², Michael Cuttica³, Ruben Mylvaganam³, S. Chris Malaisrie⁴, Ryan Avery¹, Daniel Schimmel², Yasmin Raza², Jordyn Durkin³, Li-Yueh Hsu⁵, Donny Nieto¹, Daniel C. Lee², Benjamin H. Freed², and Daniel Kim^1,6

¹Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States, ²Division of Cardiology, Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States, ³Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States, ⁴Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States, ⁵Department of Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD, United States, ⁶Department of Biomedical Engineering, Northwestern University, Evanston, IL, United States

Synopsis

Keywords: Heart Failure, Heart, Right Heart Failure, Cardiac Perfusion

Motivation: Little is known about the right ventricular (RV) perfusion reserve in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and whether pulmonary thromboendarterectomy (PTE) surgery improves RV perfusion.

Goal(s): This study sought to assess whether PTE improves RV perfusion in CTEPH patients and whether RV perfusion reserve correlates with invasive pulmonary hemodynamics.

Approach: We prospectively enrolled 6 CTEPH subjects undergoing PTE, performed stress-rest MRI and right heart catheterization, and calculated RV myocardial perfusion reserve pre and post PTE.

Results: RV perfusion reserve is improved in CTEPH with PTE, correlates with invasive pulmonary hemodynamics, and may serve as a non-invasive marker for monitoring treatment efficacy.

Impact: This study demonstrates feasibility of utilizing right ventricular perfusion reserve as an imaging marker for evaluation of pulmonary thromboendarterectomy (PTE) in chronic thromboembolic pulmonary hypertension (CTEPH) patients.

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