Pulmonary Capillary Wedge Pressure Estimation Using Statistical Shape Models

Abhijit Adhikary, Adelaide De Vecchi, Pablo Lamata
King's College London


Abstract

We evaluated the performance of statistical shape models (SSMs) derived from short-axis (SAX) cardiac magnetic resonance imaging (CMR) to estimate pulmonary capillary wedge pressure (PCWP) in a cohort of 68 cases with heart failure with preserved ejection fraction (HFpEF) and dyspnea. We obtained a 5% improvement in performance (R2 = 0.36) using 3 principal component analysis (PCA) modes compared to the existing state-of-theart non-invasive method (R2 = 0.31), which uses a linear combination of left ventricular (LV) mass and left-atrial (LA) volume to estimate PCWP. We also evaluated the linear formula on our dataset and noticed that inconsistent LV mass-PCWP correlations limited predictive performance while the correlation between PCWP and LA volume calculated from 3D meshes was on par (R2 = 0.30). Furthermore, manually calculated LA volume using the voxel-calculation method had the highest individual predictive performance (R2 = 0.33) followed by PCA mode 1 (R2 = 0.32). These findings underscore the potential of SSMs derived from CMR for non-invasive PCWP estimation in HFpEF patients, suggesting avenues for further improvement and clinical application.