Cardiac magnetic resonance (CMR) was recently reported to predict mean pulmonary capillary wedge pressure (PCWP). However, there is a paucity of data on its accuracy for estimation of PCWP in patients with normal left ventricular (LV) ejection fraction (EF). We sought to examine its accuracy against the invasive gold standard and to compare it with the accuracy of comprehensive echocardiography. Stable patients with EF of ≥50% who underwent right heart catheterization, CMR, and echocardiographic imaging within 1 week were included. Pulmonary capillary wedge pressure was estimated by CMR using a previously validated equation where PCWP is estimated based on the left atrial maximum volume and LV mass. Echocardiographic estimation of PCWP was based on 2016 American Society of Echocardiography/European Association of Cardiovascular Imaging guidelines, taking into account the presence of myocardial disease. The mean age of the 79 patients was 55 ± 15 years, and 58.2% were female. There were 33 patients with PCWP >15 mm Hg by right heart catheterization. Cardiac magnetic resonance prediction of PCWP had an area under the curve (AUC) = 0.72. In comparison, echocardiographic prediction of PCWP showed a higher accuracy (AUC = 0.87 vs AUC = 0.72; = .008). In patients with normal LV EF, CMR estimation of mean PCWP based on LV mass and left atrial volume has modest accuracy for detecting patients with mean PCWP >15 mm Hg. Comprehensive echocardiography predicts elevated PCWP with higher accuracy in comparison with CMR.

中文翻译：

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无创预测左心室射血分数正常患者的肺毛细血管楔压：心脏磁共振与综合超声心动图的比较

最近报道心脏磁共振（CMR）可以预测平均肺毛细血管楔压（PCWP）。然而，关于其评估左心室 (LV) 射血分数 (EF) 正常患者 PCWP 的准确性的数据很少。我们试图根据侵入性金标准检查其准确性，并将其与综合超声心动图的准确性进行比较。 EF≥50%、1周内接受右心导管检查、CMR和超声心动图检查的稳定患者纳入研究。肺毛细血管楔压通过 CMR 使用先前验证的方程进行估计，其中 PCWP 根据左心房最大容积和左心室质量进行估计。 PCWP 的超声心动图评估基于 2016 年美国超声心动图协会/欧洲心血管影像协会指南，并考虑到心肌疾病的存在。 79 名患者的平均年龄为 55 ± 15 岁，其中 58.2% 为女性。有 33 名患者经右心导管检查 PCWP >15 mm Hg。 PCWP 的心脏磁共振预测曲线下面积 (AUC) = 0.72。相比之下，超声心动图预测 PCWP 显示出更高的准确性（AUC = 0.87 vs AUC = 0.72；= .008）。在 LV EF 正常的患者中，基于 LV 质量和左心房容积的平均 PCWP 的 CMR 估计对于检测平均 PCWP >15 mm Hg 的患者具有一定的准确性。与 CMR 相比，综合超声心动图预测 PCWP 升高的准确性更高。