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      Main pulmonary arterial wall shear stress correlates with invasive hemodynamics and stiffness in pulmonary hypertension.

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          Abstract

          Pulmonary hypertension (PH) is associated with proximal pulmonary arterial remodeling characterized by increased vessel diameter, wall thickening, and stiffness. In vivo assessment of wall shear stress (WSS) may provide insights into the relationships between pulmonary hemodynamics and vascular remodeling. We investigated the relationship between main pulmonary artery (MPA) WSS and pulmonary hemodynamics as well as markers of stiffness. As part of a prospective study, 17 PH patients and 5 controls underwent same-day four-dimensional flow cardiac magnetic resonance imaging (4-D CMR) and right heart catheterization. Streamwise velocity profiles were generated in the cross-sectional MPA in 45° increments from velocity vector fields determined by 4-D CMR. WSS was calculated as the product of hematocrit-dependent viscosity and shear rate generated from the spatial gradient of the velocity profiles. In-plane average MPA WSS was significantly decreased in the PH cohort compared with that in controls (0.18 ± 0.07 vs. 0.32 ± 0.08 N/m(2); P = 0.01). In-plane MPA WSS showed strong inverse correlations with multiple hemodynamic indices, including pulmonary resistance (ρ = -0.74, P < 0.001), mean pulmonary pressure (ρ = -0.64, P = 0.006), and elastance (ρ = -0.70, P < 0.001). In addition, MPA WSS had significant associations with markers of stiffness, including capacitance (ρ = 0.67, P < 0.001), distensibility (ρ = 0.52, P = 0.013), and elastic modulus (ρ = -0.54, P = 0.01). In conclusion, MPA WSS is decreased in PH and is significantly associated with invasive hemodynamic indices and markers of stiffness. 4-D CMR-based assessment of WSS may represent a novel methodology to study blood-vessel wall interactions in PH.

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          Author and article information

          Journal
          Pulm Circ
          Pulmonary circulation
          University of Chicago Press
          2045-8932
          2045-8932
          Mar 2016
          : 6
          : 1
          Affiliations
          [1 ] Division of Cardiology, National Jewish Health, Denver, Colorado, USA; Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA.
          [2 ] Division of Radiology, National Jewish Health, Denver, Colorado, USA.
          [3 ] Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA.
          [4 ] Division of Cardiology, National Jewish Health, Denver, Colorado, USA.
          [5 ] Department of Mechanical Engineering, University of Colorado Boulder, Boulder, Colorado, USA.
          [6 ] Department of Bioengineering, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado, USA; BEF and KSH are co-senior authors.
          [7 ] Division of Cardiology, National Jewish Health, Denver, Colorado, USA; BEF and KSH are co-senior authors.
          Article
          PC2013254
          10.1086/685024
          4809665
          27076906

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