Cardiovascular Hemodynamics Assessment Using Magnetic Resonance Imaging

Cardiovascular magnetic resonance (CMR) has emerged as a powerful non-invasive modality for quantifying haemodynamic parameters in both research and clinical settings. Techniques such as phase-contrast velocity mapping, first-pass perfusion and advanced four-dimensional (4D) flow imaging enable direct measurement of blood flow velocities, volumetric flow rates and derived metrics including pulmonary transit time (PTT) and pulmonary blood volume index (PBVi). Automated image analysis tools incorporating machine learning have further enhanced reproducibility and throughput, facilitating the integration of quantitative CMR biomarkers into routine protocols. Applications span assessment of left and right ventricular function, diastolic filling pressures, pulmonary vascular resistance and congestion in disorders such as heart failure, pulmonary hypertension, systemic sclerosis and post-transplant diastolic dysfunction. By providing comprehensive insights into global and regional flow dynamics without ionising radiation, CMR haemodynamics supports personalised treatment planning and risk stratification, with particular value in longitudinal monitoring of therapeutic interventions.

Research from Nature Portfolio

Recent studies have examined stress-induced pulmonary circulation biomarkers in heart transplant recipients and comparison cohorts. Under pharmacological vasodilator stress, pulmonary transit time and its heart-rate-corrected counterpart were measured from first-pass perfusion datasets, revealing prolonged values in transplant patients indicative of subclinical diastolic impairment. Novel stress-to-rest ratio parameters demonstrated potential to distinguish early dysfunction, emphasising the utility of dynamic CMR to uncover haemodynamic abnormalities not evident in resting conditions.

Cardiovascular Hemodynamics Assessment Using Magnetic Resonance Imaging publication trend

The graph below shows the total number of articles in cardiovascular hemodynamics assessment using magnetic resonance imaging across all publications each year (not limited to Nature Index journals).

Technical terms

Pulmonary transit time (PTT): Interval for contrast bolus to travel from right to left ventricular cavities, reflecting cardiopulmonary flow dynamics.

Pulmonary blood volume index (PBVi): Product of PTT and cardiac index, indexed to body surface area, indicating pulmonary vascular blood volume.

Phase-contrast MRI: CMR technique that encodes velocity into image phase, enabling direct measurement of blood flow velocities and volumetric flow rates.

First-pass perfusion: Dynamic imaging of contrast agent passage through the myocardium or blood pool, used to derive transit times and perfusion maps.

4D flow CMR: Time-resolved, three-dimensional velocity mapping across the cardiac cycle, allowing comprehensive quantification of complex flow patterns.

References

1. Association of pulmonary transit time by cardiac magnetic resonance with heart failure hospitalization in a large prospective cohort with diverse cardiac conditions. Journal of Cardiovascular Magnetic Resonance (2023).
2. Prognostic Value of Pulmonary Transit Time and Pulmonary Blood Volume Estimation Using Myocardial Perfusion CMR. JACC Cardiovascular Imaging (2021).
3. Pulmonary blood volume indexed to lung volume is reduced in newly diagnosed systemic sclerosis compared to normals – a prospective clinical cardiovascular magnetic resonance study addressing pulmonary vascular changes. Journal of Cardiovascular Magnetic Resonance (2013).
4. Stress pulmonary circulation parameters assessed by a cardiovascular magnetic resonance in patients after a heart transplant. Scientific Reports (2022).