Target/background is a noninvasive technique that can be used to simultaneously evaluate pulmonary arterial pressure and myocardial perfusion in patients with connective tissue disease and congenital heart disease, according to a new study published in Annals of Noninvasive Electrocardiology.

This technique is of particularly high value for patients with severe pulmonary arterial hypertension (PAH), the authors said. PAH can develop as a complication of connective tissue disease. It can also be associated with congenital heart disease.

Researchers from China evaluated the application value of myocardial perfusion imaging in PAH associated with connective tissue disease. They retrospectively analyzed 88 patients diagnosed with connective tissue disease between January 2018 and December 2020.

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Of these, 58 patients also had PAH. Based on their mean pulmonary artery pressures measured by right heart catheterization, these patients were grouped into 3 as having mild, moderate, or severe PAH. 

Read more about PAH comorbidities

Pearson correlation analysis revealed that the right ventricle target/background negatively correlated with the 6-Minute Walk Distance test and positively correlated with N-terminal B-type natriuretic peptide, a hormone produced by the heart in response to changes in pressure inside the heart and a measure of heart function. 

Target/background also showed a good positive correlation with mean pulmonary arterial pressure, total pulmonary resistance, and pulmonary vascular resistance. Finally, it showed a negative correlation with right ventricle stroke volume.

“[Target/backgound] was of the most diagnostic value for severe PAH, and its correlation with severe PAH was stronger than that with mild PAH and moderate PAH,” the researchers said. 

However, because the sample size in this study is quite small, the findings cannot be generalized to all patients. It is also important to note that myocardial perfusion imaging is a semiquantitative method to assess pulmonary artery pressure and is not completely accurate.


Wang Z, Li J, Wang X et al. Evaluation of pulmonary arterial pressure in patients with connective tissue disease-associated pulmonary arterial hypertension by myocardial perfusion imaging. Ann Noninvas Electro. Published online December 15, 2021. doi:10.1111/anec.12927