PMID- 23826118 OWN - NLM STAT- MEDLINE DCOM- 20140305 LR - 20211021 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 8 IP - 6 DP - 2013 TI - Paradoxical interventricular septal motion as a major determinant of late gadolinium enhancement in ventricular insertion points in pulmonary hypertension. PG - e66724 LID - 10.1371/journal.pone.0066724 [doi] LID - e66724 AB - BACKGROUND: This study investigated the major clinical determinants of late gadolinium enhancement (LGE) at ventricular insertion points (VIPs) commonly seen in patients with pulmonary hypertension (PH). METHODS: Forty-six consecutive PH patients (mean pulmonary artery pressure >/=25 mmHg at rest) and 21 matched controls were examined. Right ventricular (RV) morphology, function and LGE mass volume at VIPs were assessed by cardiac magnetic resonance (CMR). Radial motion of the left ventricular (LV) wall and interventricular septum (IVS) was assessed by speckle-tracking echocardiography. Paradoxical IVS motion index was then calculated. Univariate and multivariate regression analysis were conducted to characterize the relationship between LGE volume at VIPs and PH-related clinical indices, including the paradoxical IVS motion index. RESULTS: Mean pulmonary arterial pressure (MPAP) of PH patients was 38+/-9 mmHg. LGE at VIPs was observed in 42 of 46 PH patients, and the LGE volume was 2.02 mL (0.47-2.99 mL). Significant correlations with LGE volume at VIPs were observed for MPAP (r = 0.50) and CMR-derived parameters [RV mass index (r = 0.53), RV end-diastolic volume index (r = 0.53), RV ejection fraction (r = -0.56), and paradoxical IVS motion index (r = 0.77)]. In multiple regression analysis, paradoxical IVS motion index alone significantly predicted LGE volume at VIPs (p<0.001). CONCLUSIONS: LGE at VIPs seen in patients with PH appears to reflect altered IVS motion rather than elevated RV pressure or remodeling. Long-term studies would be of benefit to characterize the clinical relevance of LGE at VIPs. FAU - Sato, Takahiro AU - Sato T AD - First Department of Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan. FAU - Tsujino, Ichizo AU - Tsujino I FAU - Ohira, Hiroshi AU - Ohira H FAU - Oyama-Manabe, Noriko AU - Oyama-Manabe N FAU - Ito, Yoichi M AU - Ito YM FAU - Noguchi, Teruo AU - Noguchi T FAU - Yamada, Asuka AU - Yamada A FAU - Ikeda, Daisuke AU - Ikeda D FAU - Watanabe, Taku AU - Watanabe T FAU - Nishimura, Masaharu AU - Nishimura M LA - eng PT - Journal Article DEP - 20130624 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - AU0V1LM3JT (Gadolinium) SB - IM MH - Case-Control Studies MH - Echocardiography MH - *Gadolinium MH - Humans MH - Hypertension, Pulmonary/*diagnostic imaging/physiopathology MH - Prospective Studies MH - Reproducibility of Results MH - Ventricular Septum/*physiopathology PMC - PMC3691198 COIS- Competing Interests: The authors have declared that no competing interests exist. EDAT- 2013/07/05 06:00 MHDA- 2014/03/07 06:00 PMCR- 2013/06/24 CRDT- 2013/07/05 06:00 PHST- 2013/04/11 00:00 [received] PHST- 2013/05/09 00:00 [accepted] PHST- 2013/07/05 06:00 [entrez] PHST- 2013/07/05 06:00 [pubmed] PHST- 2014/03/07 06:00 [medline] PHST- 2013/06/24 00:00 [pmc-release] AID - PONE-D-13-15258 [pii] AID - 10.1371/journal.pone.0066724 [doi] PST - epublish SO - PLoS One. 2013 Jun 24;8(6):e66724. doi: 10.1371/journal.pone.0066724. Print 2013.