Journal article
Reproducibility and Changes in Vena Caval Blood Flow by Using 4D Flow MRI in Pulmonary Emphysema and Chronic Obstructive Pulmonary Disease (COPD): The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Substudy
Radiology, Vol.292(3), pp.585-594
09/2019
DOI: 10.1148/radiol.2019182143
PMCID: PMC6736177
PMID: 31335282
Abstract
BackgroundChronic obstructive pulmonary disease (COPD) is associated with hemodynamic changes in the pulmonary vasculature. However, cardiac effects are not fully understood and vary by phenotype of chronic lower respiratory disease.PurposeTo use four-dimensional (4D) flow MRI for comprehensive assessment of the right-sided cardiovascular system, assess its interrater and intraobserver reproducibility, and examine associations with venous return to the right heart in individuals with chronic COPD and emphysema.Materials and MethodsThe Multi-Ethnic Study of Atherosclerosis COPD substudy prospectively recruited participants who smoked and who had COPD and nested control participants from population-based samples. Electrocardiography and respiratory gated 4D flow 1.5-T MRI was performed at three sites with full volumetric coverage of the thoracic vessels in 2014-2017 with postbronchodilator spirometry and inspiratory chest CT to quantify percent emphysema. Net flow, peak velocity, retrograde flow, and retrograde fraction were measured on 14 analysis planes. Interrater reproducibility was assessed by two independent observers, and the principle of conservation of mass was employed to evaluate the internal consistency of flow measures. Partial correlation coefficients were adjusted for age, sex, race/ethnicity, height, weight, and smoking status.ResultsAmong 70 participants (29 participants with COPD [mean age, 73.5 years ± 8.1 {standard deviation}; 20 men] and 41 control participants [mean age, 71.0 years ± 6.1; 22 men]), the interrater reproducibility of the 4D flow MRI measures was good to excellent (intraclass correlation coefficient range, 0.73-0.98), as was the internal consistency. There were no statistically significant differences in venous flow parameters according to COPD severity (
> .05). Greater percent emphysema at CT was associated with greater regurgitant flow in the superior and inferior caval veins and tricuspid valve (adjusted
= 0.28-0.55; all
< .01), particularly in the superior vena cava.ConclusionFour-dimensional flow MRI had good-to-excellent observer variability and flow consistency. Percent emphysema at CT was associated with statistically significant differences in retrograde flow, greatest in the superior vena cava.© RSNA, 2019
See also the editorial by Choe in this issue.
Details
- Title: Subtitle
- Reproducibility and Changes in Vena Caval Blood Flow by Using 4D Flow MRI in Pulmonary Emphysema and Chronic Obstructive Pulmonary Disease (COPD): The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Substudy
- Creators
- Ozair Rahman - Columbia UniversityMichael Markl - Northwestern UniversityPallavi Balte - Columbia UniversityHaben Berhane - Northwestern UniversityCarmen BlankenKenichiro Suwa - Northwestern UniversityStephen Dashnaw - Columbia UniversityOliver Wieben - University of Wisconsin–MadisonDavid A Bluemke - University of Wisconsin–MadisonMartin R Prince - Columbia UniversityJoao LimaErin Michos - Johns Hopkins UniversityBharath Ambale-VenkateshEric A Hoffman - University of IowaAntoinette S Gomes - University of California at Los AngelesKarol Watson - University of California, Los AngelesYanping Sun - Columbia UniversityJames Carr - Northwestern UniversityR Graham Barr - Columbia University
- Resource Type
- Journal article
- Publication Details
- Radiology, Vol.292(3), pp.585-594
- DOI
- 10.1148/radiol.2019182143
- PMID
- 31335282
- PMCID
- PMC6736177
- ISSN
- 0033-8419
- eISSN
- 1527-1315
- Grant note
- N01HC95169 / NHLBI NIH HHS N01HC95161 / NHLBI NIH HHS R01 HL093081 / NHLBI NIH HHS N01HC95164 / NHLBI NIH HHS N01HC95160 / NHLBI NIH HHS R01 HL112986 / NHLBI NIH HHS N01HC95167 / NHLBI NIH HHS N01HC95159 / NHLBI NIH HHS N01HC95163 / NHLBI NIH HHS UL1 RR024156 / NCRR NIH HHS R01 HL077612 / NHLBI NIH HHS N01HC95166 / NHLBI NIH HHS S10 OD018526 / NIH HHS UL1 TR000040 / NCATS NIH HHS N01HC95168 / NHLBI NIH HHS UL1 TR001079 / NCATS NIH HHS N01HC95165 / NHLBI NIH HHS P30 DK054759 / NIDDK NIH HHS N01HC95162 / NHLBI NIH HHS
- Language
- English
- Date published
- 09/2019
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984318704502771
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