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Title: The assessment of pulmonary haemodynamics with magnetic resonance imaging in pulmonary hypertension
Author: Saba, Tarek Sami
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2005
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In this thesis we set out to investigate whether anatomical and blood flow measurements made with MRI can detect and quantify raised pulmonary artery pressure at cardiac catheterisation. We then looked to see whether MRI has any advantages over Doppler echocardiography, the current gold standard non-invasive investigation. We enrolled twenty-eight subjects who were undergoing cardiac catheterisation and Doppler echocardiography for investigation of suspected pulmonary hypertension at the Scottish Pulmonary Vascular Unit between September 1999 and March 2001. We used MRI to measure right and left ventricular mass, volume, and wall thickness, and aortic and pulmonary artery diameter. We calculated a novel ventricular mass indeed by dividing right ventricular mass by left ventricular mass. We then performed a flow quantification in the right pulmonary artery to measure mean and peak velocity of blood flow, acceleration time and ejection time, and calculated the ratio of acceleration time over ejection time. Finally we attempted to study the changes in these variables following straight leg raising exercise. In summary, we have shown that anatomical measurements made in the cardiopulmonary circulation with MRI can be used to estimate pulmonary artery pressure with greater accuracy than doppler echocardiography. These estimates are likely to be more reliable than those provided by echocardiography, and may also give a measure of the recent burden of pulmonary vascular disease. An analogy may be made with the use of glycosylated haemoglobin instead of glucose in diabetes; pulmonary artery pressure fluctuates on a minute by minute basis whereas anatomical measurements reflect sustained changes in pulmonary haemodynamics. Furthermore, we have shown that MRI measurements of blood flow are sensitive and specific indicators of pulmonary hypertension, and can be used to study exercise-related changes in blood flow.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available