A Practical and Advanced Approach to CMR in Pediatric Patients with Pulmonary Hypertension-A Practical and Advanced Approach to CMR in Pediatric Patients with Pulmonary Hypertension

Video Transcription

Video Summary

The conference opened the fourth C4 Conference on Congenital Cardiac MRI, welcoming more than 300 participants worldwide. The organizers explained the webinar format: a case/theme-based discussion using live chat questions, with two panelists presenting in conversation. They also highlighted prior recorded webinars available on the SCMR website.<br /><br />The main scientific focus was pediatric pulmonary hypertension (PH) and the role of cardiac MRI (CMR). Dr. Wynne Truong reviewed PH pathophysiology, emphasizing how increased pulmonary vascular resistance raises right ventricular afterload, leading first to compensatory RV hypertrophy and then dilation and failure. She stressed ventricular-vascular coupling, septal shift, and the important impact of PH on left ventricular filling and function. She summarized evidence that MRI markers such as RV ejection fraction, RV/LV volumes, septal curvature, pulmonary artery stiffness, and flow measures are useful prognostic indicators in PH.<br /><br />Dr. Vivek Muthurangu discussed how CMR can be done efficiently in PH patients, often in under 10 minutes for function and flow, especially using real-time imaging. He emphasized practical clinical use of RV ejection fraction and septal curvature, both for prognosis and therapy monitoring. He also described MRI-guided cardiac catheterization and hybrid approaches that combine invasive pressure measurement with MR flow for accurate pulmonary vascular resistance assessment.<br /><br />The speakers then expanded into research topics: wall shear stress, pulse wave velocity, exercise MRI, 4D flow, vorticity, energy loss, and ventricular-ventricular/vascular-vascular interactions. They concluded that MRI is increasingly valuable not only for research but for clinical decision-making in pediatric PH, especially when used to track RV function, load, and response to therapy.

Keywords

congenital cardiac MRI

pediatric pulmonary hypertension

cardiac MRI

right ventricular function

ventricular-vascular coupling

pulmonary vascular resistance

septal curvature

RV ejection fraction

MRI-guided catheterization

4D flow MRI

exercise MRI