Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2026
Noninvasive estimation of right atrial pressure using cardiac magnetic resonance in severe tricuspid regurgitation.
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Kim Jihoon, Son Jihee, Kim Onyou, Choi Ki Hong, Yang Jeong Hoon, Kim Eun Kyoung, Chang Sung-A, Lee Sang-Chol, Park Seung Woo, Kim Sung Mok, Park Sung-Ji
Аннотация
BACKGROUND: While right atrial pressure (RAP) reflects disease severity and carries prognostic value in patients with severe tricuspid regurgitation (TR), its noninvasive estimation remains limited in accuracy. The aim of this study was to evaluate the ability of cardiovascular magnetic resonance imaging (CMR) to estimate RAP by identifying relevant imaging parameters in patients with severe TR.
METHODS: Between September 2021 and January 2026, 47 consecutive patients who underwent cardiac catheterization and CMR for severe TR were enrolled from a tertiary center. In addition to conventional parameters, right ventricular (RV) and right atrial (RA) strain were measured from apical four-chamber images of CMR. Pressure profiles including the mean RAP were obtained via cardiac catheterization.
RESULTS: The median age was 69 years, and secondary TR was the predominant etiology (83.0%). The mean RAP was 10.0 mmHg, and the median interval between catheterization and CMR was 1 day. Among volumetric parameters, indexed RV end-diastolic volume (RVEDVi; r = 0.58, p<0.001), indexed RV end-systolic volume (r = 0.55, p<0.001), and indexed RA end-systolic area (r = 0.33, p = 0.024) were significantly associated with invasively measured RAP. Among functional parameters, RV ejection fraction and RV longitudinal strain were not significantly associated with RAP. In contrast, RA longitudinal strain (r = -0.59, p<0.001) and RA radial strain (r = -0.48, p<0.001) showed significant associations. In a multivariable linear regression model, RVEDVi and RA longitudinal strain remained significantly associated with RAP. The area under the curve for predicting mean RAP >10 mmHg was 0.78 for RVEDVi and 0.82 for RA longitudinal strain.
CONCLUSION: RVEDVi and RA longitudinal strain were significantly associated with invasively measured RAP in patients with severe TR. These findings suggest that CMR has potential as a noninvasive tool for estimating RAP in this population.
METHODS: Between September 2021 and January 2026, 47 consecutive patients who underwent cardiac catheterization and CMR for severe TR were enrolled from a tertiary center. In addition to conventional parameters, right ventricular (RV) and right atrial (RA) strain were measured from apical four-chamber images of CMR. Pressure profiles including the mean RAP were obtained via cardiac catheterization.
RESULTS: The median age was 69 years, and secondary TR was the predominant etiology (83.0%). The mean RAP was 10.0 mmHg, and the median interval between catheterization and CMR was 1 day. Among volumetric parameters, indexed RV end-diastolic volume (RVEDVi; r = 0.58, p<0.001), indexed RV end-systolic volume (r = 0.55, p<0.001), and indexed RA end-systolic area (r = 0.33, p = 0.024) were significantly associated with invasively measured RAP. Among functional parameters, RV ejection fraction and RV longitudinal strain were not significantly associated with RAP. In contrast, RA longitudinal strain (r = -0.59, p<0.001) and RA radial strain (r = -0.48, p<0.001) showed significant associations. In a multivariable linear regression model, RVEDVi and RA longitudinal strain remained significantly associated with RAP. The area under the curve for predicting mean RAP >10 mmHg was 0.78 for RVEDVi and 0.82 for RA longitudinal strain.
CONCLUSION: RVEDVi and RA longitudinal strain were significantly associated with invasively measured RAP in patients with severe TR. These findings suggest that CMR has potential as a noninvasive tool for estimating RAP in this population.
Предметные рубрики MeSH
HumansTricuspid Valve InsufficiencyAtrial PressureFemaleAgedPredictive Value of TestsAtrial Function, RightSeverity of Illness IndexMaleMagnetic Resonance Imaging, CineMiddle AgedCardiac CatheterizationVentricular Function, RightReproducibility of ResultsTricuspid ValveRetrospective StudiesAged, 80 and overMagnetic Resonance Imaging