Characterizing extravascular lung water—A dual-contrast agent extracellular volume approach by cardiovascular magnetic resonance
ABSTRACT: Background: Pathological extravascular lung water is a facet of decompensated congestive heart failure that current cardiovascular magnetic resonance (CMR) methods fail to quantify. CMR can measure total lung water density, but cannot distinguish between intravascular and extravascular fl...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Journal of Cardiovascular Magnetic Resonance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664725000456 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849332857650020352 |
|---|---|
| author | Felicia Seemann Rim N. Halaby Andrea Jaimes Kendall O’Brien Peter Kellman Daniel A. Herzka Robert J. Lederman Adrienne E. Campbell-Washburn |
| author_facet | Felicia Seemann Rim N. Halaby Andrea Jaimes Kendall O’Brien Peter Kellman Daniel A. Herzka Robert J. Lederman Adrienne E. Campbell-Washburn |
| author_sort | Felicia Seemann |
| collection | DOAJ |
| description | ABSTRACT: Background: Pathological extravascular lung water is a facet of decompensated congestive heart failure that current cardiovascular magnetic resonance (CMR) methods fail to quantify. CMR can measure total lung water density, but cannot distinguish between intravascular and extravascular fluid, and thus is not diagnostic. Therefore, we develop and evaluate a novel method to measure extravascular lung water by distinguishing intravascular from extracellular fluid compartments using two different contrast agents, extracellular gadolinium chelates and iron-based intravascular ferumoxytol. Methods: We created two porcine models of pulmonary edema: reversible catheter-induced mitral regurgitation to induce extravascular lung water (n = 5); intravascular volume overload using rapid colloid infusion (n = 5); and compared to normal controls (n = 8). We sequentially acquired lung T1 maps and lung water density maps at 0.55T with native, gadolinium-based, and ferumoxytol contrast, from which we calculated the extracellular volume fraction (ECV) and blood plasma volume fraction in the pulmonary tissue, respectively. We computed extravascular ECV as the difference in ECV and plasma volume fractions. Extravascular lung water volumes were estimated. Results: In the mitral regurgitation model, baseline vs mitral regurgitation ECVextravascular increased from 27 ± 4.1% to 32 ± 1.9% (p = 0.006), and extravascular lung water volume increased from 105 ± 19 mL to 143 ± 15 mL (p = 0.048). Plasma volume fraction was similar at baseline vs mitral regurgitation (43 ± 4.2% vs 46 ± 5.4%, p = 0.26). Compared to naïve pigs, we measured higher plasma volume fractions in the intravascular volume-loaded model (42 ± 4.7% vs 51 ± 2.7%, p = 0.0054), but no differences in ECVextravascular (21 ± 4.6% vs 21 ± 3.6%, p = 0.99) or extravascular lung water volume (67 ± 13 mL vs 89 ± 24 mL, p = 0.11). Assessing the regional distribution, the plasma volume was higher posteriorly, indicating gravitational dependency, whereas, the extravascular lung water was higher anteriorly. Conclusion: Extravascular lung ECV measurements and derived lung water volumes corresponded well with predicted increases in extravascular and intravascular pulmonary fluid in animal models. This method may enable mechanistic studies of lung water in patients with dyspnea. |
| format | Article |
| id | doaj-art-ea78fd7233774b45bcce52533c9cf4b7 |
| institution | Kabale University |
| issn | 1097-6647 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-ea78fd7233774b45bcce52533c9cf4b72025-08-20T03:46:05ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127110188310.1016/j.jocmr.2025.101883Characterizing extravascular lung water—A dual-contrast agent extracellular volume approach by cardiovascular magnetic resonanceFelicia Seemann0Rim N. Halaby1Andrea Jaimes2Kendall O’Brien3Peter Kellman4Daniel A. Herzka5Robert J. Lederman6Adrienne E. Campbell-Washburn7Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USACardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USACardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USACardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USACardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USACardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USA; Department of Radiology, Case Western Reserve School of Medicine, Cleveland, Ohio 44106, USACardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USACardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892, USA; Corresponding author.ABSTRACT: Background: Pathological extravascular lung water is a facet of decompensated congestive heart failure that current cardiovascular magnetic resonance (CMR) methods fail to quantify. CMR can measure total lung water density, but cannot distinguish between intravascular and extravascular fluid, and thus is not diagnostic. Therefore, we develop and evaluate a novel method to measure extravascular lung water by distinguishing intravascular from extracellular fluid compartments using two different contrast agents, extracellular gadolinium chelates and iron-based intravascular ferumoxytol. Methods: We created two porcine models of pulmonary edema: reversible catheter-induced mitral regurgitation to induce extravascular lung water (n = 5); intravascular volume overload using rapid colloid infusion (n = 5); and compared to normal controls (n = 8). We sequentially acquired lung T1 maps and lung water density maps at 0.55T with native, gadolinium-based, and ferumoxytol contrast, from which we calculated the extracellular volume fraction (ECV) and blood plasma volume fraction in the pulmonary tissue, respectively. We computed extravascular ECV as the difference in ECV and plasma volume fractions. Extravascular lung water volumes were estimated. Results: In the mitral regurgitation model, baseline vs mitral regurgitation ECVextravascular increased from 27 ± 4.1% to 32 ± 1.9% (p = 0.006), and extravascular lung water volume increased from 105 ± 19 mL to 143 ± 15 mL (p = 0.048). Plasma volume fraction was similar at baseline vs mitral regurgitation (43 ± 4.2% vs 46 ± 5.4%, p = 0.26). Compared to naïve pigs, we measured higher plasma volume fractions in the intravascular volume-loaded model (42 ± 4.7% vs 51 ± 2.7%, p = 0.0054), but no differences in ECVextravascular (21 ± 4.6% vs 21 ± 3.6%, p = 0.99) or extravascular lung water volume (67 ± 13 mL vs 89 ± 24 mL, p = 0.11). Assessing the regional distribution, the plasma volume was higher posteriorly, indicating gravitational dependency, whereas, the extravascular lung water was higher anteriorly. Conclusion: Extravascular lung ECV measurements and derived lung water volumes corresponded well with predicted increases in extravascular and intravascular pulmonary fluid in animal models. This method may enable mechanistic studies of lung water in patients with dyspnea.http://www.sciencedirect.com/science/article/pii/S1097664725000456Lung waterFerumoxytolExtracellular volumeDual-agent |
| spellingShingle | Felicia Seemann Rim N. Halaby Andrea Jaimes Kendall O’Brien Peter Kellman Daniel A. Herzka Robert J. Lederman Adrienne E. Campbell-Washburn Characterizing extravascular lung water—A dual-contrast agent extracellular volume approach by cardiovascular magnetic resonance Journal of Cardiovascular Magnetic Resonance Lung water Ferumoxytol Extracellular volume Dual-agent |
| title | Characterizing extravascular lung water—A dual-contrast agent extracellular volume approach by cardiovascular magnetic resonance |
| title_full | Characterizing extravascular lung water—A dual-contrast agent extracellular volume approach by cardiovascular magnetic resonance |
| title_fullStr | Characterizing extravascular lung water—A dual-contrast agent extracellular volume approach by cardiovascular magnetic resonance |
| title_full_unstemmed | Characterizing extravascular lung water—A dual-contrast agent extracellular volume approach by cardiovascular magnetic resonance |
| title_short | Characterizing extravascular lung water—A dual-contrast agent extracellular volume approach by cardiovascular magnetic resonance |
| title_sort | characterizing extravascular lung water a dual contrast agent extracellular volume approach by cardiovascular magnetic resonance |
| topic | Lung water Ferumoxytol Extracellular volume Dual-agent |
| url | http://www.sciencedirect.com/science/article/pii/S1097664725000456 |
| work_keys_str_mv | AT feliciaseemann characterizingextravascularlungwateradualcontrastagentextracellularvolumeapproachbycardiovascularmagneticresonance AT rimnhalaby characterizingextravascularlungwateradualcontrastagentextracellularvolumeapproachbycardiovascularmagneticresonance AT andreajaimes characterizingextravascularlungwateradualcontrastagentextracellularvolumeapproachbycardiovascularmagneticresonance AT kendallobrien characterizingextravascularlungwateradualcontrastagentextracellularvolumeapproachbycardiovascularmagneticresonance AT peterkellman characterizingextravascularlungwateradualcontrastagentextracellularvolumeapproachbycardiovascularmagneticresonance AT danielaherzka characterizingextravascularlungwateradualcontrastagentextracellularvolumeapproachbycardiovascularmagneticresonance AT robertjlederman characterizingextravascularlungwateradualcontrastagentextracellularvolumeapproachbycardiovascularmagneticresonance AT adrienneecampbellwashburn characterizingextravascularlungwateradualcontrastagentextracellularvolumeapproachbycardiovascularmagneticresonance |