Accuracy of chest radiography in predicting pulmonary hypertension: A case-control study

Miniati, Massimo; Monti, Simonetta; Airò, Edoardo; Pancani, Roberta; Formichi, Bruno; Bauleo, Carolina; Marini, Carlo

doi:10.1016/j.thromres.2013.12.019

Cited by 16 publications

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References 27 publications

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“… 14 , 15 Dilatation of the pulmonary artery trunk and of the RV with pruning of peripheral pulmonary vessels were regarded as suggestive of chronic thromboembolic pulmonary hypertension (CTEPH). 16 …”

Section: Methodsmentioning

confidence: 99%

Predictors of Pulmonary Infarction

et al. 2015

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Section: Methodsmentioning

confidence: 99%

Predictors of Pulmonary Infarction

et al. 2015

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“…Signs of PH on CXR include isolated enlargement of the RV, right descending pulmonary artery diameter >16 mm, and pruning of the pulmonary vessels. Miniati et al [76] studied the accuracy of these findings in predicting PH and found their weighted sensitivity to be 96.9% and weighted specificity to be 99.8%. Computed tomography (CT) of the chest has also been used to evaluate the severity of PH.…”

Section: Diagnosismentioning

confidence: 99%

Pulmonary Hypertension and Right Heart Dysfunction in Chronic Lung Disease

Zangiabadi

Pasquale

Sajkov

2014

BioMed Research International

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Group 3 pulmonary hypertension (PH) is a common complication of chronic lung disease (CLD), including chronic obstructive pulmonary disease (COPD), interstitial lung disease, and sleep-disordered breathing. Development of PH is associated with poor prognosis and may progress to right heart failure, however, in the majority of the patients with CLD, PH is mild to moderate and only a small number of patients develop severe PH. The pathophysiology of PH in CLD is multifactorial and includes hypoxic pulmonary vasoconstriction, pulmonary vascular remodeling, small vessel destruction, and fibrosis. The effects of PH on the right ventricle (RV) range between early RV remodeling, hypertrophy, dilatation, and eventual failure with associated increased mortality. The golden standard for diagnosis of PH is right heart catheterization, however, evidence of PH can be appreciated on clinical examination, serology, radiological imaging, and Doppler echocardiography. Treatment of PH in CLD focuses on management of the underlying lung disorder and hypoxia. There is, however, limited evidence to suggest that PH-specific vasodilators such as phosphodiesterase-type 5 inhibitors, endothelin receptor antagonists, and prostanoids may have a role in the treatment of patients with CLD and moderate-to-severe PH.

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“…[16] CXR has a high sensitivity (96.9%) and specificity (99.1%) for detection of PAH when pre-test probability is 50% or more. [17] Miniati et al [17] suggested that CXR findings that are suggestive of PAH are sufficient to warrant further investigation by RHC and that a normal CXR does not exclude the presence of PH. The severity of PH, however, cannot be correlated with CXR changes.…”

Section: Discussionmentioning

confidence: 99%

Occult pulmonary arterial hypertension in patients with previous pulmonary tuberculosis

Kalla

Miri

Seedat

2020

Afr J Thorac Crit Care Med

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Background. Pulmonary tuberculosis (TB) still causes a significant public healthcare burden. Despite successful treatment, TB can lead to permanent lung damage and pulmonary hypertension (PH). PH can also occur in the absence of significant lung damage, leading clinicians to question whether pulmonary TB may cause pulmonary arterial hypertension (PAH), an entity that has not been otherwise described. Objectives. To determine the prevalence of PAH in patients previously treated for TB. Methods. We recruited 20 participants who were previously treated for TB and had no other underlying risk factors for the development of PH. The participants underwent electrocardiography (ECG), chest radiography, lung function tests and echocardiography (ECHO). Data from these non-invasive investigations were evaluated to determine findings that were suggestive of PH. Results. At a median duration of 30 months from diagnosis of TB, no participant had echocardiography findings that were suggestive of PH (pulmonary artery pressure (PAP) ≥40 mmHg). However, there was a negative correlation between the time from diagnosis and right ventricular dysfunction assessed by measuring a tricuspid annular plane systolic excursion (r=-0.5136; p=0.0205). Furthermore, one-third of the participants (n=7) had one or more ECG features supporting PH and 85% of the participants (n=17) demonstrated at least one chest X-ray (CXR) feature of PH. Conclusion. Although our study did not demonstrate ECHO findings supporting PH, ECG and CXR modalities were suggestive. Therefore, future studies consisting of larger cohorts and including the use of other sensitive modalities such as computed tomography are warranted. Moreover, these studies will need to determine whether the entity of PAH secondary to previously treated pulmonary TB exists.

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Accuracy of chest radiography in predicting pulmonary hypertension: A case-control study

Cited by 16 publications

References 27 publications

Predictors of Pulmonary Infarction

Predictors of Pulmonary Infarction

Pulmonary Hypertension and Right Heart Dysfunction in Chronic Lung Disease

Occult pulmonary arterial hypertension in patients with previous pulmonary tuberculosis

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