Cardiac magnetic resonance imaging-derived septum swing index detects pulmonary hypertension: A diagnostic study.

ABSTRACT

Background and Objectives: Because of pressure differences between the pulmonary artery and aorta, the ventricular septum moves in a swinging motion that is commonly observed on cardiac MR (CMR) cine sequences in patients with pulmonary hypertension (PH). We aimed to assess the use of septum swing index (SSI) derived by CMR for detecting PH. Methods: We retrospectively identified consecutive patients with suspected PH who underwent right heart catheterization (RHC) and CMR at a PH referral center between July 2019 and December 2020. The diagnostic accuracy of SSI for identifying PH (mean pulmonary artery pressure [mPAP] ≥ 25 mmHg) was assessed by receiver operating characteristic curves, sensitivity, specificity, and positive and negative predictive values. Results: A total of 105 patients (mean age 47.8 ± 15.0 years; 68 females) were included in the final analysis. SSI and mPAP were negatively correlated in the total study population and patients with PH, but not in patients without PH. SSI was an independent predictor of PH (adjusted odds ratio 12.9, 95% confidence interval 3.6 to 45.5, P = 0.003). The area under the curve for SSI was 0.91, with a cut-off value of 0.9673 yielding the best balance of sensitivity (86.4%), specificity (88.2%), positive predictive value (97.4%), negative predictive value (55.6%), and accuracy (86.7%) for detecting PH. Conclusions: Septum swing index was lower in patients with PH and is a simple, reliable method for detecting PH.