Qingqing Lu, Abstract Co-Author: Nothing to Disclose

Yan Han, Abstract Co-Author: Nothing to Disclose

Dong Li MD, Abstract Co-Author: Nothing to Disclose

Zhang Zhang, Presenter: Nothing to Disclose

Tielian Yu, Abstract Co-Author: Nothing to Disclose

Cardiac magnetic resonance (CMR) has been an accurate and reproducible tool to assessment of right ventricular (RV) morphology and function, which are important factors in the outcome of patients with pulmonary arterial hypertension (PAH). Iloprost inhalation has shown an effective therapy for severe primary pulmonary hypertension. This study aims to investigate acute RV response to inhalation of aerosolized iloprost in patients with PAH using CMR.

Between March 2012 and March 2014, 53 patients with PAH(39.5 years ±12; 5 male) underwent CMR before and after inhalation of iloprost with a single dose of 20μg over 15-20 minutes. The CMR images were analyzed to obtain the RV morphology and function parameters before and after iloprost inhalation, including end-diastolic volume(EDV), end-systolic volume(ESV), stroke volume(SV), ejection fraction(EF), cardiac output(CO), end-diastolic area(EDA) and end-systolic area(ESA). Percentage of RV area change was also calculated [%RVAC=(EDA-ESA)/EDA]. Paired Samples t Test was used to compare the differences of RV morphology and function parameters.

After iloprost inhalation, all patients showed significant decrease in EDV[(207.8±88.4)mlvs. (201.0±88.8)ml, P<0.001)] and ESV[(142.5±77.9) ml vs. (129.0±74.8)ml,P<0.001]. Whereas, there were significant increase in SV[(65.3±22.5)mlvs.(72.1±24.2)ml,P<0.001], EF[(34.8±12.5)%vs. (39.4±12.8)%,P<0.001], CO[(5.3±1.9)L/minvs.(5.5±2.1)L/min,P=0.01], and %RVAC[(19.4±13.0) vs. (23.8±11.2), P<0.001] .

Inhalation of iloprost can improve RV morphology and function in patients with PAH, and evaluation of the acute response with CMR is feasibility.

CMR has value in providing direct changes in RV morphology and function to therapy in patients with PAH.

Lu, Q, Han, Y, Li, D, Zhang, Z, Yu, T, Acute Response of Right Ventricular Morphology and Function to Iloprost Inhalations in Patients with Pulmonary Arterial Hypertension: Noninvasive Evaluation with Cardiac Magnetic Resonance Imaging.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013562.html