Noninvasive prediction of pulmonary hemodynamics in chronic thromboembolic pulmonary hypertension by electrocardiogram-gated computed tomography.
Eur J Radiol Open
; 8: 100384, 2021.
Article
em En
| MEDLINE
| ID: mdl-34712746
ABSTRACT
PURPOSE:
The aim of the study was to investigate the potential of electrocardiogram (ECG)-gated computed tomography pulmonary angiography (CTPA) as a predictor of disease severity in patients with chronic thromboembolic pulmonary hypertension (CTEPH).METHOD:
Forty-five CTEPH patients with a mean age of 63.8 years±12.7 y (±standard deviation) who had undergone ECG-gated CTPA and right heart catheterization (RHC) were included in the study. Right ventricular to left ventricular volume ratio (RVV/LVV), diameter ratio on 4-chamber view (RVD4CH/LVD4CH), pulmonary trunk (PT) diameter, PT to aortic diameter ratio (PT/A), and septal angle were correlated to mean pulmonary artery pressure (mPAP). Moreover, RVV/LVV and RVD4CH/LVD4CH were adjusted to pulmonary diameter index (PADi) and PT/A index. Areas under the curve (AUC) for predicting mPAP above 40 mmHg, 35 mmHg, and 30 mmHg were calculated.RESULTS:
RVD4CH/LVD4CH revealed the strongest correlation to mPAP before (r = 0.6507) and after (r = 0.7650; p < 0.0001) PT/A adjustment. The AUCs for predicting pH with mPAP over 40 mmHg and 30 mmHg were 0.9229 and 0.864, respectively. A cutoff value of 1.298 enabled prediction of pH with mPAP over 40 mmHg with a sensitivity, specificity, positive predictive, and negative predictive value of 80.00 %, 95.83 %, 88.46 %, and 94.12 %, respectively. Intra- and interobserver variability were excellent for all parameters.CONCLUSION:
Combining different and easily evaluable ECG-gated CTPA parameters enables excellent prediction of pulmonary hemodynamics in CTEPH patients. Ventricular diameter ratio on 4-chamber view adjusted by the PT/A ratio yielded the best correlation to mPAP.
4CH, four-chamber view; AUC, Area under the curve; CI, Confidence interval; CT, Computed tomography; CTEPH; CTEPH, Chronic thromboembolic pulmonary hypertension; CTPA; CTPA, Computed tomography pulmonary angiography; ECG, Electrocardiogram; HU, Hounsfield units; ICC, intra-class concordance correlation coefficient; LV, Left ventricular; LVD, Left ventricular diameter; LVV, Left ventricular volume; MDCT, Multidetector computed tomography; NPV, Negative predictive value; PADi, Pulmonary artery diameter index; PH, Pulmonary hypertension; PPV, Positive predictive value; PT, Pulmonary trunk; Pulmonary hypertension; RHC, Right heart catheterization; ROC, Receiver operating characteristics; RV, Right ventricular; RVD, Right ventricular diameter; RVV, Right ventricular volume; Right heart catheterization; SD, Standard deviation; mPAP, mean pulmonary artery pressure
Texto completo:
1
Base de dados:
MEDLINE
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Eur J Radiol Open
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Alemanha