Table 3.
New non-invasive imaging techniques for pulmonary hypertension (PH).
| Modality | Parameter | Comments |
|---|---|---|
| Echo | Speckle-tracking RV strain (188) | Normal <-25%, definitely abnormal >-20%; ≥−19% is significantly associated with all-cause mortality |
| Three-dimensional echo (3DE) (189) | Comparable correlation to MRI; real-time 3DE could become a time- and cost-saving alternative to MRI | |
| Exercise stress echo (172) | RVSP increase ≤30 mmHg with exercise suggests worse prognosis | |
| MRI | RV Tagging strain (190) | Predictors of clinical deterioration and death in patients with PAH |
| Fast strain-encoded (SENC) imaging (191) | Real-time through-plane tagging technique that allows direct measurement of regional function via one free-breathing heart beat | |
| RV myocardial T1 mapping (192) | Enables measurement of myocardial extracellular volume; may be useful for detecting early stages of chronic PH, prior to onset of overt, macroscopic fibrosis | |
| Nuclear & CT | RV FDG PET (193) | Higher uptake is associated with clinical worsening of PH and can be used in hybrid imaging |
| Dual-energy CT (194) | Can provide incremental pulmonary blood volume maps and be used in hybrid imaging |
CT, computed tomography; Echo, echocardiography; FDG, fluorodeoxyglucose; MRI, magnetic resonance imaging; PAH, pulmonary arterial hypertension; PET, positron emission tomography; RV, right ventricle; RVSP, right ventricular systolic pressure.