Pulmonary Hypertension (PHT) is usually accompanied with alterations in vascular hemodynamics and remodelling of pulmonary artery architecture and is poorly described by non-invasive diagnostic imaging modalities. In the clinical setting, these illness characteristics could be interesting biomarkers. Thirty-three patients with pulmonary hypertension and seventeen healthy controls were included in this retrospective clinical investigation. Measurements of pulmonary artery diameters, bifurcation distances, and angles were used to evaluate architectural change using a 3D-contrast enhanced angiography. Wall shear stress, kinetic energy, vorticity, and directional flow dynamics were used to evaluate hemodynamics using 4D-flow Magnetic Resonance Imaging (MRI). Independent samples student’s t-tests were used to compare parameters. Pearson’s correlation was used to perform correlational analysis. The major and right branches of the pulmonary artery were dilated in PHT patients (p=0.05). Furthermore, bifurcation distances in the left and right pulmonary arteries increased in these patients (p=0.05). In the pulmonary artery, wall shear stress, maximal kinetic energy, and energy loss were all reduced (p=0.001). Peak velocities and right ventricle ejection fraction were shown to be related (r=0.527, p=0.05). These findings imply that pulmonary artery remodelling and hemodynamic alterations could be used as MRI biomarkers for PHT in the future.
