Pulmonary Artery Stiffness by Cardiac Magnetic Resonance Imaging Predicts Major Adverse Cardiovascular Events in patients with Chronic Obstructive Pulmonary Disease

Abstract

In this prospective pilot study, we aimed to evaluate the ability of cardiac magnetic resonance imaging (CMR) parameters of right ventricular function and pulmonary artery stiffness to identify pulmonary hypertension (PH), predict major adverse cardiovascular events (MACEs) in patients with secondary PH due to chronic obstructive pulmonary disease (COPD), and to estimate a prospective sample size necessary for a reliable power of the study. Thirty consecutive patients with COPD and suspected secondary PH were assessed by clinical examination, the six minute walk test, echocardiography, right heart catheterization and CMR, and followed-up for a mean period of 16 months to identify MACEs (cardiac death, ventricular tachyarrhythmia, and heart failure). Among CMR parameters of pulmonary artery stiffness, pulse wave velocity (PWV) yielded the best sensitivity (93.5%) and specificity (92.8%) for identifying PH, as diagnosed by cardiac catheterization. Moreover, PWV proved to be a valuable predictor of MACEs (HR = 4.75, 95% CI 1.00 to 22.59, p = 0.03). In conclusion, PWV by phase-contrast CMR can accurately identify PH in patients with COPD and may help stratify prognosis.