Right Ventricular Perfusion Reserve Predicts Response to Pulmonary Thromboendarterectomy

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.