{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T09:53:10Z","timestamp":1785232390778,"version":"3.55.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,4,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Pulmonary arterial hypertension (PAH) manifests with progressive right ventricular (RV) dysfunction, which eventually impairs the left ventricular function. We hypothesized that 4\u2010dimensional\u2013flow magnetic resonance imaging can detect flow hemodynamic changes associated with efficient intracardiac flow during noninvasive inhaled nitric oxide (iNO) challenge in children with PAH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Children with PAH (n=10) underwent 2 same\u2010day separate iNO challenge tests using: (1) 4\u2010dimensional\u2013flow magnetic resonance imaging and (2) standard catheterization hemodynamics. Intracardiac flow was evaluated using the particle tracking 4\u2010flow component analysis technique evaluating the\n              <jats:italic>direct flow<\/jats:italic>\n              ,\n              <jats:italic>retained inflow<\/jats:italic>\n              ,\n              <jats:italic>delayed ejection flow<\/jats:italic>\n              , and\n              <jats:italic>residual volume<\/jats:italic>\n              . Respective flow hemodynamic changes were compared with the corresponding catheterization iNO challenge results. The RV analysis revealed decreased direct flow in patients with PAH when compared with controls (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and increase in residual volume (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Similarly, the left ventricular analysis revealed decreased direct flow in patients with PAH when compared with controls (\n              <jats:italic>P<\/jats:italic>\n              =0.004) and increased proportion of the residual volume (\n              <jats:italic>P<\/jats:italic>\n              =0.014). There was an increase in the RV direct flow during iNO delivery (\n              <jats:italic>P<\/jats:italic>\n              =0.009), with parallel decrease in the residual volume (\n              <jats:italic>P<\/jats:italic>\n              =0.008).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Children with PAH have abnormal biventricular flow associated with impaired diastolic filling. The flow efficiency is significantly improved in the RV on iNO administration with no change in the left ventricle. The changes in the RV flow have occurred despite the minimal change in catheterization hemodynamics, suggesting that flow hemodynamic evaluation might provide more quantitative insights into vasoreactivity testing in PAH.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020548","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T19:21:15Z","timestamp":1624303275000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Short\u2010Term Effects of Inhaled Nitric Oxide on Right Ventricular Flow Hemodynamics by 4\u2010Dimensional\u2013Flow Magnetic Resonance Imaging in Children With Pulmonary Arterial Hypertension"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1794-3262","authenticated-orcid":false,"given":"Michal","family":"Sch\u00e4fer","sequence":"first","affiliation":[{"name":"Division of Cardiology Heart Institute Children's Hospital ColoradoUniversity of Colorado DenverAnschutz Medical Campus Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2227-6265","authenticated-orcid":false,"given":"Benjamin S.","family":"Frank","sequence":"additional","affiliation":[{"name":"Division of Cardiology Heart Institute Children's Hospital ColoradoUniversity of Colorado DenverAnschutz Medical Campus Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2541-3402","authenticated-orcid":false,"given":"D. Dunbar","family":"Ivy","sequence":"additional","affiliation":[{"name":"Division of Cardiology Heart Institute Children's Hospital ColoradoUniversity of Colorado DenverAnschutz Medical Campus Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven H.","family":"Abman","sequence":"additional","affiliation":[{"name":"Division of Pulmonology Breathing Institute Children's Hospital ColoradoUniversity of Colorado DenverAnschutz Medical Campus Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6918-6411","authenticated-orcid":false,"given":"Kurt R.","family":"Stenmark","sequence":"additional","affiliation":[{"name":"Department of Critical Care and Pulmonary Medicine University of Colorado DenverAnschutz Medical Campus Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max B.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Section of Congenital Heart Surgery Heart Institute Children's Hospital ColoradoUniversity of Colorado DenverAnschutz Medical Campus Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorna P.","family":"Browne","sequence":"additional","affiliation":[{"name":"Department of Radiology Children's Hospital ColoradoUniversity of Colorado DenverAnschutz Medical Campus Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex J.","family":"Barker","sequence":"additional","affiliation":[{"name":"Department of Radiology Children's Hospital ColoradoUniversity of Colorado DenverAnschutz Medical Campus Aurora CO USA"},{"name":"Department of Bioengineering University of Colorado DenverAnschutz Medical Campus Aurora CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kendall S.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Department of Radiology Children's Hospital ColoradoUniversity of Colorado DenverAnschutz Medical Campus Aurora CO 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