Article Data

  • Views 1036
  • Dowloads 191

Original Research

Open Access

Axial CT measured main pulmonary artery diameter to predict the presence and degree of pulmonary hypertension

  • Ji Ung Na1
  • Jang Hee Lee1
  • Dong Hyuk Shin1,*,

1Department of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 03181 Seoul, Republic of Korea

DOI: 10.22514/sv.2023.124 Vol.20,Issue 2,February 2024 pp.38-45

Submitted: 16 August 2023 Accepted: 20 September 2023

Published: 08 February 2024

*Corresponding Author(s): Dong Hyuk Shin E-mail: sinndhk@skku.edu; shindhk@daum.net

Abstract

We performed this study to investigate if main pulmonary artery (mPA) diameter measured by axial chest computed tomography (CT) can predict the presence and degree of echocardiography-measured pulmonary hypertension (ePH) among emergency department (ED) patients. This retrospective cross-sectional study enrolled patients who underwent both chest CT and echocardiography within 24 h at the ED. The ePH was estimated using right ventricular systolic pressure (RVSP). RVSP <40 mmHg was classified as normal; 40–49 mmHg, mild ePH; 50–75 mmHg, moderate ePH; and ≥76 mmHg, severe ePH. Among 485 adult patients, 297 (61.2%) had normal RVSP and mean mPA of 30.3 mm. The numbers of patients with mild, moderate and severe ePH were 92 (19.0%), 85 (17.5%) and 11 (2.3%) with corresponding mean mPA diameters of 32.4, 34.5 and 35.9 mm, respectively. The best mPA diameters for predicting mild, moderate and severe ePH were 30.6, 31.8 and 33.8 mm, with area under the receiver operating characteristic curve of 0.697, 0.727 and 0.797 and sensitivities of 72.9%, 71.9% and 81.8%, respectively. Axial CT-measured mPA diameter can predict the presence and degree of ePH among ED patients. If the CT-measured mPA diameter is greater than 30.6 mm, the possibility of pulmonary hypertension should be considered and applied to the patient’s treatment.


Keywords

Pulmonary artery; Pulmonary hypertension; Computed tomography; Thoracic radiography


Cite and Share

Ji Ung Na,Jang Hee Lee,Dong Hyuk Shin. Axial CT measured main pulmonary artery diameter to predict the presence and degree of pulmonary hypertension. Signa Vitae. 2024. 20(2);38-45.

References

[1] Chang KY, Duval S, Badesch DB, Bull TM, Chakinala MM, De Marco T, et al. Mortality in pulmonary arterial hypertension in the modern era: early insights from the pulmonary hypertension association registry. Journal of the American Heart Association. 2022; 11: e024969.

[2] Mehta S, Vachiéry J. Pulmonary hypertension: the importance of correctly diagnosing the cause. European Respiratory Review. 2016; 25: 372–380.

[3] Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. European Heart Journal. 2022; 43: 3618–3731.

[4] Mandras SA, Mehta HS, Vaidya A. Pulmonary hypertension: a brief guide for clinicians. Mayo Clinic Proceedings. 2020; 95: 1978–1988.

[5] Peacock A, Ross K. Pulmonary hypertension: a contraindication to the use of b-adrenoceptor blocking agents. Thorax. 2010; 65: 454–455.

[6] Brown LM, Chen H, Halpern S, Taichman D, McGoon MD, Farber HW, et al. Delay in recognition of pulmonary arterial hypertension. Chest. 2011; 140: 19–26.

[7] Gelzinis TA. Pulmonary hypertension in 2021: part I—definition, classification, pathophysiology, and presentation. Journal of Cardiothoracic and Vascular Anesthesia. 2022; 36: 1552–1564.

[8] Marra AM, Attanasio U, Cuomo A, Rainone C, D’Agostino A, Carannante A, et al. Mildly elevated pulmonary hypertension: gray zone or already a disease? Heart Failure Clinics. 2023; 19: 1–9.

[9] Janda S, Shahidi N, Gin K, Swiston J. Diagnostic accuracy of echocardiography for pulmonary hypertension: a systematic review and meta-analysis. Heart. 2011; 97: 612–622.

[10] Ni J, Yan P, Liu S, Hu Y, Yang K, Song B, et al. Diagnostic accuracy of transthoracic echocardiography for pulmonary hypertension: a systematic review and meta-analysis. BMJ Open. 2019; 9: e033084.

[11] Freitas D, Alner S, Demetrescu C, Antonacci G, Proudlove N. Time to be more efficient: reducing wasted transthoracic echocardiography (TTE) diagnostic appointment slots at Guy’s and St Thomas’ NHS Trust. BMJ Open Quality. 2023; 12: e002317.

[12] Aluja Jaramillo F, Gutierrez FR, Díaz Telli FG, Yevenes Aravena S, Javidan-Nejad C, Bhalla S. Approach to pulmonary hypertension: from CT to clinical diagnosis. RadioGraphics. 2018; 38: 357–373.

[13] Alhamad EH, Al-Boukai AA, Al-Kassimi FA, Alfaleh HF, Alshamiri MQ, Alzeer AH, et al. Prediction of pulmonary hypertension in patients with or without interstitial lung disease: reliability of CT findings. Radiology. 2011; 260: 875–883.

[14] Wilcox SR, Faridi MK, Camargo CA. Intensive care unit admission for patients with pulmonary hypertension presenting to U.S. emergency departments. The American Journal of Emergency Medicine. 2021; 50: 237–241.

[15] Wilcox SR, Faridi MK, Camargo CA Jr. Demographics and outcomes of pulmonary hypertension patients in United States emergency departments. The Western Journal of Emergency Medicine. 2020; 21: 714–721.

[16] Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982; 143: 29–36.

[17] Bujang MA, Sa’at N, Tg Abu Bakar Sidik TMI, Chien Joo L. Sample size guidelines for logistic regression from observational studies with large population: emphasis on the accuracy between statistics and parameters based on real life clinical data. Malaysian Journal of Medical Sciences. 2018; 25: 122–130.

[18] Seo HS, Lee H. Assessment of right ventricular function in pulmonary hypertension with multimodality imaging. Journal of Cardiovascular Imaging. 2018; 26: 189.

[19] Mandoli GE, Landra F, Chiantini B, Sciaccaluga C, Pastore MC, Focardi M, et al. Tricuspid regurgitation velocity and mean pressure gradient for the prediction of pulmonary hypertension according to the new hemodynamic definition. Diagnostics. 2023; 13: 2619.

[20] Soofi MA, Shah MA, AlQadhi AM, AlAnazi AM, Alshehri WM, Umair A. Sensitivity and specificity of pulmonary artery pressure measurement in echocardiography and correlation with right heart catheterization. Journal of the Saudi Heart Association. 2021; 33: 228–236.

[21] Brennan JM, Blair JE, Goonewardena S, Ronan A, Shah D, Vasaiwala S, et al. Reappraisal of the use of inferior vena cava for estimating right atrial pressure. Journal of the American Society of Echocardiography. 2007; 20: 857–861.

[22] Moceri P, Baudouy D, Chiche O, Cerboni P, Bouvier P, Chaussade C, et al. Imaging in pulmonary hypertension: focus on the role of echocardiography. Archives of Cardiovascular Diseases. 2014; 107: 261–271.

[23] Truong QA, Massaro JM, Rogers IS, Mahabadi AA, Kriegel MF, Fox CS, et al. Reference values for normal pulmonary artery dimensions by noncontrast cardiac computed tomography. Circulation: Cardiovascular Imaging. 2012; 5: 147–154.

[24] Frazier AA, Burke AP. The imaging of pulmonary hypertension. Seminars in Ultrasound, CT and MRI. 2012; 33: 535–551.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.3 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top