The Journal of Practical Medicine >

2026 , Vol. 42 >Issue 10: 1720 - 1728

DOI: https://doi.org/10.3969/j.issn.1006-5725.2026.10.005

Chronic Disease Control

The value of cardiac magnetic resonance imaging-derived perimeter-area ratio in ventricular remodeling of chronic pulmonary thromboembolism

  • Jie DU ,
  • Yanlin GUO ,
  • Hanchi YU ,
  • Anqi LIU ,
  • Linfeng XI ,
  • Shuai ZHANG ,
  • Wanmu XIE ,
  • Yong CHENG ,
  • Min LIU
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  • 1.Chinese Academy of Medical Sciences & Peking Union Medical College，Beijing 100730，Beijing，China
    2.Department of Radiology，China?Japan Friendship Hospital，Beijing 100029，Beijing，China
    3.Institute of Clinical Medical Sciences，China?Japan Friendship Hospital，Beijing 100029，Beijing，China
    4.Peking University China?Japan Friendship School of Clinical Medicine，Beijing 100029，Beijing，China
    5.Department of Pulmonary and Critical Care Medicine，China-Japan Friendship Hospital，Beijing 100029，Beijing，China
    6.College of Information Science and Technology，Beijing University of Chemical Technology，Beijing 100029，Beijing，China

Received date: 2026-02-07

  Online published: 2026-05-27

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Abstract

Objective This study aims to investigate the value of the perimeter-area ratio （PAR） derived from non-contrast cardiac magnetic resonance （CMR） imaging in assessing ventricular remodeling and risk stratification in patients with chronic pulmonary thromboembolism （CPTE）. Methods A total of 53 patients with CPTE were prospectively enrolled，including 16 with chronic thromboembolic pulmonary disease （CTEPD） and 37 with chronic thromboembolic pulmonary hypertension （CTEPH）. Additionally，53 age- and sex-matched healthy volunteers were recruited as controls. All patients underwent CMR and right heart catheterization within 24 hours. Biventricular PAR values were calculated and compared among the three groups at three short-axis levels on end-diastolic and end-systolic cine images. Diagnostic performance was assessed using receiver operating characteristic curve analysis，and associations between PAR and hemodynamic parameters were examined using Spearman’s correlation. Results Compared with CTEPD patients，right ventricular （RV） PAR was significantly lower in CTEPH patients，with the most pronounced difference observed at the apical level （P < 0.05）. At this level，RV-PAR demonstrated excellent diagnostic performance in identifying CPTE and distinguishing its subtypes，with area under the curve （AUC） values ranging from 0.872 to 0.990，along with high sensitivity and specificity. RV-PAR was negatively correlated with afterload indices and positively correlated with perfusion and output parameters （all P < 0.05）. Conclusions CMR-derived PAR sensitively captures microstructural remodeling of the right ventricle in CPTE patients， serving as a potential non-invasive biomarker for disease severity assessment and risk stratification. Notably，the cardiac apex emerges as the most sensitive region for adaptive changes in the right ventricle.

Key words： chronic pulmonary thromboembolism; cardiac magnetic resonance imaging; perimeter-area ratio; ventricular remodeling

Cite this article

Jie DU , Yanlin GUO , Hanchi YU , Anqi LIU , Linfeng XI , Shuai ZHANG , Wanmu XIE , Yong CHENG , Min LIU . The value of cardiac magnetic resonance imaging-derived perimeter-area ratio in ventricular remodeling of chronic pulmonary thromboembolism[J]. The Journal of Practical Medicine, 2026 , 42(10) : 1720 -1728 . DOI: 10.3969/j.issn.1006-5725.2026.10.005

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