CT-Determined Pulmonary Artery Diameters in Predicting Pulmonary Hypertension

Kuriyama, Kinya; Gamsu, G; Stern, Robert; Cann, Christopher E.; Herfkens, Robert J.; Brundage, Bruce H.

doi:10.1097/00004424-198401000-00005

Cited by 267 publications

(156 citation statements)

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“…Although the distending effect of an increase in Ppa on the vessel wall has already been evoked (1,10), the results of the present study suggest that the value of the PAH cannot be satisfactorily assessed by means of measurements of MPA CSA. In this connection, if the proposed MRI method was used as a primary test to indicate catheterization, patient 15, whose presented CSA value was high, in the absence of PAH, would have avoided the catheterization.…”

Section: Discussionmentioning

confidence: 53%

Noninvasive assessment of pulmonary arterial hypertension by MR phase-mapping method

Laffon¹,

Laurent

Bernard

et al. 2001

Journal of Applied Physiology

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Marthan. Noninvasive assessment of pulmonary arterial hypertension by MR phase-mapping method. J Appl Physiol 90: [2197][2198][2199][2200][2201][2202] 2001.-We describe a magnetic resonance (MR) imaging method that emphasizes pressure wave velocity to noninvasively assess pulmonary arterial hypertension. Both the blood flow and the corresponding vessel crosssectional area (CSA) were measured by MR phase mapping in the main pulmonary artery (MPA) in 15 patients. MPA pressures were also measured, in the same patients, by right-side heart catheterization. Two significant relationships were established: 1) between the pressure wave velocity in the MPA and the mean pressure in the MPA (Ppa) writing pressure wave velocity ϭ 9.25 Ppa Ϫ 202.51 (r ϭ 0.82) and 2) between the ratio of pressure wave velocity to the systolic blood velocity peak in the MPA (R) and the mean pressure in the MPA writing R ϭ 0.68 Ppa Ϫ 4.33 (r ϭ 0

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Section: Discussionmentioning

confidence: 53%

Noninvasive assessment of pulmonary arterial hypertension by MR phase-mapping method

Laffon¹,

Laurent

Bernard

et al. 2001

Journal of Applied Physiology

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“…We also used Spearman correlation coefficients to express the relationship between Ppa and PFTs, %LAA 2950 , Pa O 2 , and other variables previously described as indicators of pulmonary arterial pressure, including MPAD and MPAD/AoD (17,(19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Hypertension and Computed Tomography Measurement of Small Pulmonary Vessels in Severe Emphysema

Matsuoka¹,

Washko²,

Yamashiro³

et al. 2010

Am J Respir Crit Care Med

155

158

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Rationale: Vascular alteration of small pulmonary vessels is one of the characteristic features of pulmonary hypertension in chronic obstructive pulmonary disease. The in vivo relationship between pulmonary hypertension and morphological alteration of the small pulmonary vessels has not been assessed in patients with severe emphysema. Objectives: We evaluated the correlation of total cross-sectional area of small pulmonary vessels (CSA) assessed on computed tomography (CT) scans with the degree of pulmonary hypertension estimated by right heart catheterization. Methods: In 79 patients with severe emphysema enrolled in the National Emphysema Treatment Trial (NETT), we measured CSA less than 5 mm 2 (CSA ,5 ) and 5 to 10 mm 2 (CSA 5210 ), and calculated the percentage of total CSA for the lung area (%CSA ,5 and %CSA 5-10 , respectively). The correlations of %CSA ,5 and %CSA 5-10 with pulmonary arterial mean pressure (Ppa) obtained by right heart catheterization were evaluated. Multiple linear regression analysis using Ppa as the dependent outcome was also performed. Measurements and Main Results: The %CSA ,5 had a significant negative correlation with Ppa (r 5 20.512, P , 0.0001), whereas the correlation between %CSA 5-10 and Ppa did not reach statistical significance (r 5 20.196, P 5 0.083). Multiple linear regression analysis showed that %CSA ,5 and diffusing capacity of carbon monoxide (DL CO ) % predicted were independent predictors of Ppa (r 2 5 0.541): %CSA ,5 (P , 0.0001), and DL CO % predicted (P 5 0.022). Conclusions: The %CSA ,5 measured on CT images is significantly correlated to Ppa in severe emphysema and can estimate the degree of pulmonary hypertension.Keywords: chronic obstructive pulmonary disease; emphysema; pulmonary hypertension; CT Pulmonary hypertension is an important predictor of mortality in chronic obstructive pulmonary disease (COPD) (1-3). Various factors, including endothelial dysfunction, inflammation, and hypoxia, have been recognized as potential contributors to the development of secondary pulmonary hypertension in emphysema, but its pathogenesis has not been fully clarified. Nevertheless, it is generally recognized that vascular remodeling of small pulmonary arteries is an essential morphological feature of pulmonary hypertension; narrowing and diminution of the small pulmonary vessels have been shown on conventional angiography in emphysema (4-6). However, to our knowledge, the in vivo relationship between pulmonary hypertension and the magnitude of small pulmonary vessel morphological change has not been quantitatively assessed in severe emphysema.A recent histological study suggested that vascular remodeling leads to reduced distensibility of small pulmonary vessels and that this remodeling is closely related to pulmonary hypertension (7). Such a decrease in distensibility of small pulmonary vessels may lead to increased pulmonary vascular resistance and elevated pulmonary vascular pressure. Therefore, we hypothesized that measurements of the total cross-sectional area of small ...

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“…Pulmoner hipertansiyonun temel bulgusu santral pulmoner arterlerin genişlemesidir (Şekil 13) ve ana pulmoner arter çapına dayanarak pulmoner hipertansiyonun ciddiyeti hakkında fikir edinilebilir (36). Santral pulmoner arter çapının 2.86 cm' den büyük olmasının PAH tanısı için sensitivitesi %69; spesifisitesi %100' dür (37). Pulmoner arterin kesitsel alanı, pulmoner arter-bronş çapı oranı, pulmoner arter çapının pulmoner ven çapına oranı ve ana pulmoner arterin aort çapına oranının da pulmoner hipertansiyon ciddiyeti ile korelasyon gös-terdiğine ilişkin çalışmalar bulunmaktadır (37)(38)(39).…”

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Echocardiography and other imaging modalities in pulmonary arterial hypertension

Özben

Başaran²

2010

Anadolu Kardiyol Derg

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It is essential to diagnose pulmonary arterial hypertension in early stages of the disease. However, most patients have late diagnosis due to the lack of disease-specific symptoms and prominent findings. Although cardiac catheterization is the gold standard in the diagnosis of pulmonary arterial hypertension, noninvasive diagnostic modalities do also have major roles in the diagnosis, risk assessment and follow-up of the patients with pulmonary arterial hypertension. The focus of the present review is the clinical role of echocardiography and other imaging modalities in pulmonary arterial hypertension. ÖZETPrognozu oldukça kötü olan pulmoner arteriyel hipertansiyonda tanının hastalığın erken dönemlerinde konulması oldukça önemlidir. Ancak semptomların spesifik olmaması ve hastalık bulgularının silik olması nedeniyle, birçok hastada tanıyı koymada geç kalınmaktadır. Tanıda altın standart olarak kardiyak kateterizasyon kabul edilse de, pulmoner arteriyel hipertansiyon tanı, risk değerlendirmesi ve tedavi takibinde noninvazif tanı yöntemlerinin yeri büyüktür. Bu derlemenin konusu pulmoner arteriyel hipertansiyon tanısında kullanılan ekokardiyografi ve diğer görüntüleme yöntemleridir.

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CT-Determined Pulmonary Artery Diameters in Predicting Pulmonary Hypertension

Cited by 267 publications

References 0 publications

Noninvasive assessment of pulmonary arterial hypertension by MR phase-mapping method

Noninvasive assessment of pulmonary arterial hypertension by MR phase-mapping method

Pulmonary Hypertension and Computed Tomography Measurement of Small Pulmonary Vessels in Severe Emphysema

Echocardiography and other imaging modalities in pulmonary arterial hypertension

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