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Precapillary pulmonary hypertension causes increased biventricular hemodynamic forces

David Jones*, Elena Johnson

Elevated pulmonary vascular pressure and resistance characterise precapillary Pulmonary Hypertension (PHprecap). Since the prognosis of patients is poor, it is essential to comprehend the underlying pathophysiological mechanisms in order to direct and enhance treatment. Ventricular Hemo Dynamic Forces (HDF) is a possible early indicator of heart dysfunction that may help with therapy effectiveness assessment. Therefore, our goal was to find out whether HDF varied between patients with PHprecap and healthy controls. Patients who had PHprecap received cardiac magnetic resonance imaging with 4D flow, as well as age and sex matched healthy controls. Using the Navier-Stokes equations, biventricular HDF were calculated in three spatial directions over the course of the cardiac cycle. In all three directions, biventricular HDF (N) indexed to stroke volume (l) were bigger in patients than controls. Data are shown as median N/l for patients and controls, respectively. In precapillary pulmonary hypertension, hemodynamic force analysis provides information on pathological heart pumping processes in addition to more well established volumetric and functional data. Left ventricular hemodynamic abnormalities are mostly caused by under filling rather than intrinsic ventricular dysfunction, and the right ventricle partially makes up for the increased afterload by increasing transverse forces.

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