Pulmonary hypertension (PH) is defined as an elevated mean pulmonary artery pressure at rest (mPAP ≥ 25 mmHg), evaluated by right heart catheterization (RHC). The aim of the present study was to evaluate HRCT findings in relation to transthoracic echocardiographic data to better characterize PH in IPF patients and to identify a non-invasive composite index with high predictive value for PH in these patients. 37 IPF patients were enrolled in this retrospective study. All patients underwent a complete assessment for PH, including transthoracic Doppler echocardiography, HRCT scan and right heart catheterization. Right heart catheterization was done in 19 patients (51.3%) as pre-lung transplant assessment and in 18 patients (48.6%) to confirm PH, suspected on the basis of echocardiography. Twenty out of 37 patients (54%) were confirmed to have PH by RHC. Multivariate regression showed that the combination of sPAP, PA area measured by HRCT and the ratio of the diameter of the segmental artery to that of the adjacent bronchus in the apicoposterior segment of the left upper lobe was strongly correlated with mPAP (R2 = 0.53; p = 0.0009). The ROC analysis showed that 931.6 was the ULN for PA area, with 86% sensitivity and 61% specificity (0.839 AUC); 20.34 was the ULN for the ratio of PA area to ascending aorta diameter, with 100% sensitivity and 50% specificity (0.804 AUC). The composite index proposed in the present study could help early detection of IPF patients suspected of PH requiring confirmation by RHC (if deemed clinically necessary).

Conclusions RC-time is not constant between health and pulmonary vascular disease. A reduction in RC-time, in the context of PAH, is associated with a decrease in cardiac efficiency. RVOPF is lower in the NPH group compared to the PAH group. This implies better cardiac efficiency in the NPH group possibly due to less pulsatile loading of the RV. Haemodynamic assessments which include measures of compliance may be of utility in understanding the progression of right heart failure in PAH. -2014-206260.301 Purpose To evaluate the reliability of HRCT-parameters suggesting Pulmonary Hipertension (PH) in a population of Idiopathic Pulmonary Fibrosis (IPF) patients with or without PH at rightsided-heart-catheterization. Methods and materials The HRCT scans of 26 patients with IPF, underwent both right-sided-heart-catheterization and echocardiography, were retrospectively, blindly and independently, evaluated by one radiology resident and one experienced-radiologist (with a 10-years-experience in thoracic-radiology). P172The diameter and area of Pulmonary Artery (PA), before its bifurcation, the diameter of ascending aorta and the mid anteroposterior-diameter of the thoracic vertebra, on the same CTsection, and the widest short-axis-diameters of four segmental arteries and bronchus, in both upper and lower lobes, were measured. The diameters of left ventricle and inferior vena cava, the presence of emphisema, pericardial effusion and hiatal hernia were also evaluated. Results 15 out of 29 patients had PH at RHC. The HRCT parameters related to the mean pulmonary artery pressure (mPAP) were: the PA-area (R 2 =0.238079; p = 0.04), the ratio of the PA-area to the ascending aorta diameter (R 2 =0.215345; p = 0.0524) and above all the ratio of the diameter of segmental artery to the adjacent bronchus in the left upper lobe (R 2 =0.354973; p = 0.0006).The combination of systolic pulmonary artery pressure (sPAP), the PA-area at HRCT and the ratio of the diameter of segmental artery to the adjacent bronchus in the apicoposterior segment of the left upper lobe was strongly correlated to mPAP (R 2 =0.785163; p = 0.0001). The contribution of other echocardiographic-parameters (longitudinal STRAIN and Time-to-Peak STRAIN values, TTP) in multivariate regression analysis was not statistically significant, probably because of the small number of patients.Using the ROC Analysis we found that 931,6 is the upper limit of normal (ULN) for the PA-area, with a 86% sensitivity and 61% specificity (0.839 AUC); while 20.34 is the ULN for the ratio of the PA-area to the ascending aorta diameter, with a 100% sensitivity and 50% specificity (0.804 AUC). Conclusion (S) HRCT remains an useful tool to identify patients with PH, however the combination of HRCT and echocardiograpy improves accuracy in PH diagnosis.In the pleural zone Introduction There is no clear consensus on the management of Spontaneous pneumothorax. BTS recommends insertion of chest drain following failure of initial aspiration in large primary spontaneous pneumothorax (PSP) an...