Cardiovascular MRI–based Biventricular Perfusion Assessment in Two Patients with Chronic Thromboembolic Pulmonary Hypertension Undergoing Pulmonary Thromboendarterectomy
Chronic thromboembolic pulmonary hypertension (CTEPH) can lead to right ventricular (RV) ischemia and dysfunction due to chronic pulmonary artery obstruction and increased afterload. While cardiovascular MRI (CMR) enables noninvasive assessment of myocardial perfusion, its role in CTEPH remains unclear. The authors report adenosine stress perfusion CMR findings from two patients with CTEPH before and after pulmonary thromboendarterectomy (PTE). Both showed reduced biventricular perfusion before PTE; one demonstrated post-PTE improvement. Perfusion findings aligned with invasive hemodynamics, suggesting that CMR-derived myocardial perfusion reserve may serve as a valuable tool for assessing treatment response and RV pathophysiologic characteristics in CTEPH. <b>Keywords:</b> Cardiac, Pulmonary Arteries, Chronic Thromboembolic Pulmonary Hypertension, Pulmonary Thromboendarterectomy, Quantitative Perfusion Cardiovascular MRI, Myocardial Blood Flow, Myocardial Perfusion Reserve <i>Supplemental material is available for this article.</i> © RSNA, 2025.
Authors
- Michael J. Cuttica (ORCID: https://orcid.org/0000-0002-0084-8760)
- Stephen F. Chiu (ORCID: https://orcid.org/0000-0003-2759-9394)
- Jordyn Durkin
- Brandon Benefield (ORCID: https://orcid.org/0000-0002-4394-2300)
- Lexiaozi Fan (ORCID: https://orcid.org/0000-0002-3714-5372)
- Michael Markl (ORCID: https://orcid.org/0000-0002-7686-1128)
- Li‐Yueh Hsu (ORCID: https://orcid.org/0000-0002-0826-7290)
- Daniel Schimmel (ORCID: https://orcid.org/0000-0001-6035-7317)
- S Cohn (ORCID: https://orcid.org/0000-0001-7819-8289)
- Donny Nieto
- Ruben Mylvaganam (ORCID: https://orcid.org/0000-0002-7203-7609)
- Nour Beydoun (ORCID: https://orcid.org/0000-0002-9685-7310)
- Benjamin H. Freed (ORCID: https://orcid.org/0000-0003-1075-5047)
- S. Chris Malaisrie (ORCID: https://orcid.org/0000-0002-0704-0334)
- David Dushfunian (ORCID: https://orcid.org/0000-0002-0628-1961)
- Ryan Avery (ORCID: https://orcid.org/0000-0002-7913-0574)
- Daniel Kim (ORCID: https://orcid.org/0000-0003-2660-8973)
- Daniel Lee (ORCID: https://orcid.org/0000-0001-9447-4175)
- Yasmin Raza
- María Davó-Jiménez
Institutions
- Northwestern University (US)
- National Institutes of Health (US)
Publication Details
- Journal
- Radiology Cardiothoracic Imaging
- Published
- 2025-11-20
- DOI
- https://doi.org/10.1148/ryct.250296
- Primary Topic
- Pulmonary Hypertension Research and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00