Performance of computed tomography-derived pulmonary vasculature metrics in the diagnosis and haemodynamic assessment of pulmonary arterial hypertension |
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| Institution: | 1. Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Japan;2. Department of Biostatistics, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan;1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Children’s Hospital, Seoul, South Korea;2. Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, South Korea;1. Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino - IRCCS, Milan, Italy;2. Vascular Biology and Regenerative Medicine Unit, Centro Cardiologico Monzino - IRCCS, Milan, Italy;3. “L. Sacco” Department of Clinical and Biomedical Sciences, Università degli Studi di Milano, Casa di Cura San Pio X, Milan, Italy;4. Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy;1. Veterinary Hospital, Veterinary Medical School, Federal University of Minas Gerais, Belo Horizonte, 30123-970, Minas Gerais, Brazil;2. Molecular Pharmacology Laboratory, Health Sciences Department, University of Brasília, Distrito Federal, Brazil;3. Biochemistry and Immunology Department, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, 30123-970, Minas Gerais, Brazil;4. CellSeq Solutions, Belo Horizonte, 30160-041, Minas Gerais, Brazil;5. Genomic Sciences and Biotechnology Program, Catholic University of Brasília, Brasília, 70790-160, DF, Brazil;6. MATTER Chicago, Chicago, IL, 60 654, USA;7. The Founder Insitute, San Francisco, CA, USA;8. OneSkin Technologies, San Francisco, CA, USA |
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| Abstract: | BackgroundFew studies have addressed the value of combining computed tomography-derived pulmonary vasculature metrics for the diagnosis and haemodynamic evaluation of pulmonary arterial hypertension (PAH).Materials and methodsWe measured three computed tomography parameters for the pulmonary artery, peripheral vessels, and pulmonary veins: the ratio of the diameter of the pulmonary artery to the aorta (PA/Ao), the cross-sectional area of small pulmonary vessels <5 mm2 as a percentage of total lung area (%CSA<5), and the diameter of the right inferior pulmonary vein (PVD). The measured quantities were compared between patients with PAH (n = 45) and control subjects (n = 56), and their diagnostic performance and associations with PAH-related clinical indices, including right heart catheterization measurements, were examined.ResultsPA/Ao and %CSA<5 were significantly higher in patients with PAH than in controls. Receiver-operating characteristic curve analysis for ability to diagnose PAH showed a high area under the curve (AUC) for PA/Ao (0.95) and modest AUCs for %CSA<5 (0.75) and PVD (0.56). PA/Ao correlated positively with mean pulmonary arterial pressure and PVD correlated negatively with pulmonary vascular resistance. The %CSA<5 correlated negatively with mean pulmonary arterial pressure and pulmonary vascular resistance and positively with cardiac index. Notably, the PA/Ao and PVD values divided by %CSA<5 correlated better with right heart catheterization indices than the non-divided values.ConclusionPA/Ao, %CSA<5, and PVD are useful non-invasive pulmonary vasculature metrics, both alone and in combination, for diagnosis and haemodynamic assessment of PAH. |
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| Keywords: | Pulmonary arterial hypertension Pulmonary vasculature Pulmonary vein Computed tomography (CT) Diagnosis Haemodynamic assessment |
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