Detection of Pulmonary Hypertension with Multidetector CT and Echocardiography Alone and in Combination

Devaraj, Anand; Wells, Adrian; Meister, Mark G.; Corte, Tamera J.; Wort, Stephen J.; Hansell, David M.

doi:10.1148/radiol.09090548

Cited by 176 publications

(137 citation statements)

References 26 publications

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“…However, most of these studies were conducted in heterogeneous populations with various underlying lung diseases, thus, limiting their application to patients with COPD. [14][15][16][17][18][19][20] We showed that CT image-measured relative PA enlargement, defined as a PA:A ratio . 1, identifies patients at increased risk of COPD exacerbation and hospitalization 21 ; however, the mechanism underlying relative PA enlargement has not been clearly elucidated.…”

Section: Discussionmentioning

confidence: 99%

CT Scan-Measured Pulmonary Artery to Aorta Ratio and Echocardiography for Detecting Pulmonary Hypertension in Severe COPD

Iyer

Wells

Vishin

et al. 2014

Chest

155

183

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COPD is the third leading cause of death in the United States and is associated with signifi cant morbidity and health-care-related expenditures mostly due to acute exacerbations. 1,2 Patients with COPD may develop subclinical or overt pulmonary vascular disease, and the presence of pulmonary hypertension (PH) is an important predictor of both COPD and exacerbation-related morbidity and mortality, particularly in patients with severe disease. [3][4][5][6][7][8] Although PH can occur in patients with mild to moderate COPD because of pulmonary infl ammation and endothelial or cardiac dysfunction, it more commonly occurs and becomes clinically apparent when airfl ow limitation is severe and is believed to be primarily due to hypoxic vasoconstriction of small pulmonary arteries that result in intimal hyperplasia as well as smooth muscle hypertrophy and hyperplasia. [9][10][11] Right-sided heart catheterization (RHC) remains the gold standard for diagnosis of pulmonary vascular disease. 12 Although noninvasive strategies, such as Doppler echocardiography, allow the measurement of pulmonary artery systolic pressure (PASP), this modality is often problematic in patients with COPD because of lung hyperinfl ation and diffi culty in obtaining clear

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Section: Discussionmentioning

confidence: 99%

CT Scan-Measured Pulmonary Artery to Aorta Ratio and Echocardiography for Detecting Pulmonary Hypertension in Severe COPD

Iyer

Wells

Vishin

et al. 2014

Chest

155

183

View full text Add to dashboard Cite

show abstract

“…Although neither sign appears to be sufficiently accurate in isolation, the combination of HRCT and echocardiography was found in one study to perform better in PH detection than the use of either individual test [75].…”

Section: Diagnosismentioning

confidence: 94%

Comorbidities in interstitial lung diseases

2017

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Fibrosing lung disorders include a large number of diseases with diverse behaviour. Patients can die because of the progression of their illness, remain stable or even improve after appropriate treatment has been instituted. Comorbidities, such as acute and chronic infection, gastro-oesophageal reflux, pulmonary hypertension, lung cancer, cardiovascular diseases, and obstructive sleep apnoea, can pre-exist or develop at any time during the course of the disease and, if unidentified and untreated, may impair quality of life, impact upon the respiratory status of the patients, and ultimately lead to disease progression and death. Therefore, early identification and accurate treatment of comorbidities is essential.

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“…However, no linear correlation has been found between pulmonary artery diameter and the severity of PHT. Also, pulmonary artery dilatation can occur in the absence of PHT in patients with pulmonary fibrosis and is therefore an unreliable sign of PHT in this cohort [51]. Devaraj et al [52] showed that a composite index of the ratio of the diameter of the MPA and ascending aorta combined with echocardiography-derived right ventri- Right heart on multidetector CT…”

Section: Pulmonary Hypertensionmentioning

confidence: 80%

Right heart on multidetector CT

Gopalan

2011

BJR

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ABSTRACT. Right ventricular function plays an integral role in the pathogenesis and outcome of many cardiovascular diseases. Imaging the right ventricle has long been a challenge because of its complex geometry. In recent years there has been a tremendous expansion in multidetector row CT (MDCT) and its cardiac applications. By judicious modification of contrast medium protocol, it is possible to achieve good opacification of the right-sided cardiac chambers, thereby paving the way for exploring the overshadowed right heart. This article will describe the key features of right heart anatomy, review MDCT acquisition techniques, elaborate the various morphological and functional information that can be obtained, and illustrate some important clinical conditions associated with an abnormal right heart.

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Detection of Pulmonary Hypertension with Multidetector CT and Echocardiography Alone and in Combination

Abstract: Purpose:To test the reliability of potentially new computed tomographic (CT) indicators of pulmonary hypertension (PH) and to establish whether a combination of CT and echocardiographic measurements was more predictive of PH than either test alone.

Cited by 176 publications

References 26 publications

CT Scan-Measured Pulmonary Artery to Aorta Ratio and Echocardiography for Detecting Pulmonary Hypertension in Severe COPD

CT Scan-Measured Pulmonary Artery to Aorta Ratio and Echocardiography for Detecting Pulmonary Hypertension in Severe COPD

Comorbidities in interstitial lung diseases

Right heart on multidetector CT

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