Electrocardiogram-Gated 320-Slice Multidetector Computed Tomography for the Measurement of Pulmonary Arterial Distensibility in Chronic Thromboembolic Pulmonary Hypertension

Kasai, Hajime; Sugiura, Toshihiko; Tanabe, Nobuhiro; Sakurai, Yoshinori; Yahaba, Misuzu; Matsuura, Yukiko; Shigeta, Ayako; Kawata, Naoko; Sakao, Seiichiro; Kasahara, Yasunori

doi:10.1371/journal.pone.0111563

Cited by 13 publications

(13 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study found that the AD and AC of PA decreased in the following order: MPA, RPA, and LPA, which was consistent with the previous studies. [ 26 ] We also found that the elasticity relativity existed between AA and DA, AA and MPA, LPA and MPA, LPA and RPA, which were positively correlated. No similar research had been reported before.…”

Section: Discussionmentioning

confidence: 59%

“…This is consistent with previous research reports, including echocardiography, MRI, and CT. [ 4 , 5 , 9 , 24 , 25 ] However, the factors of pulse pressure were not taken into account in previous studies on PA elasticity. [ 25 , 26 ] In our research, pulmonary arterial elasticity was defined by the change in cross-sectional area between diastole and systole and then divided by pulse pressure difference. Our method was more comprehensive, and more consistent with the definition of arterial elasticity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Analysis of elasticity characteristics of ascending aorta, descending aorta and pulmonary artery using 640 slice-volume CT

et al. 2018

View full text Add to dashboard Cite

As the prevalence of coronary computed tomographic angiography (CCTA), it is meaningful that CCTA can provide not only the structural details of artery, but also functional information of vessel elasticity. Our aim was to explore the elasticity characteristics of ascending aorta (AA), descending aorta (DA), main pulmonary artery (MPA), left pulmonary artery (LPA), right pulmonary artery (RPA), and their relationship between each other using 640 slice-volume computed tomography (CT). Furthermore, this study will also observe their relations with age.A total of 42 subjects that were free of cardiovascular disease, high blood pressure, diabetes, and hyperlipidemia underwent CCTA on 640 slice-volume CT and were enrolled in this study. The subjects were divided into 2 groups: Group 1, age <46; Group 2, age ≥46. The aortic distensibility (AD) and aortic compliance (AC) of aorta and pulmonary artery (PA) of each group were compared.The AD and AC of PA decreased in the following order: MPA, RPA, and LPA. The correlation coefficients of different elastic parameters between different vessels were found to be different. The correlation coefficient of AD between AA and DA, AA and MPA, DA and MPA, RPA and MPA, LPA and MPA, and RPA and LPA were 0.689 (P = .000), 0.520 (P = .000), 0.393 (P = .010), 0.329 (P = .033), 0.579 (P = .000), and 0.534 (P = .000), respectively. The correlation coefficients of AC for the 6 groups mentioned above were 0.351 (P = .023), 0.470 (P = .002), 0.249 (P = .112), 0.190 (P = .228), 0.441 (P = .005), and 0.409 (P = .010), respectively. There was an age-dependent decrease of AD and AC in AA, DA, MPA, LPA (P < .05), but no difference in RPA (P > .05).The elasticity characteristics of AA, DA, MPA, LPA, and RPA could be well shown by 640 slice-volume CT. The elasticity relativity was observed and was different between AA and DA, AA and MPA, LPA and MPA, LPA and RPA. An obvious age-related decrease in vascular elasticity was found in AA, DA, MPA, and LPA, which should be taken into consideration in clinical trials and treatments for the elasticity-related cardiovascular diseases.

show abstract

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Analysis of elasticity characteristics of ascending aorta, descending aorta and pulmonary artery using 640 slice-volume CT

et al. 2018

View full text Add to dashboard Cite

show abstract

“…16 PV distensibility is a mechanical property of the pulmonary vessels defined as the relative change in pulmonary arterial diameter or area for a given change in pressure, while PV capacitance is the change in volume associated with a change in pressure (calculated as the ratio of stroke volume to pulmonary pulse pressure, SV/PP), and impedance is the ratio of the pulmonary arterial pressure waveform to the flow over the entire cardiac cycle. 16, 17 PV distensibility has been estimated with different imaging modalities including magnetic resonance imaging, 18–20 echocardiography, 21 gated CT, 22, 23 and intravascular ultrasound. 24 However, these techniques are limited in that they all estimate distensibility based on fractional change in diameter or area of the main PA or large PA segments, and do not account for the distensibility of the entire PV circuit including the medium-sized pulmonary arterioles where much of the abnormal vascular remodeling occurs in PH.…”

mentioning

confidence: 99%

Pulmonary Vascular Distensibility Predicts Pulmonary Hypertension Severity, Exercise Capacity, and Survival in Heart Failure

Malhotra

Dhakal

Eisman

et al. 2016

Circ: Heart Failure

View full text Add to dashboard Cite

Background Pulmonary vascular (PV) distensibility, defined as the percent increase in pulmonary vessel diameter per mmHg increase in pressure, permits the pulmonary arteries to increase in size to accommodate increased blood flow. We hypothesized that PV distensibility is abnormally low in patients with heart failure (HF) and serves as an important determinant of right ventricular performance and exercise capacity. Methods and Results Patients with HF and preserved ejection fraction (HFpEF, n=48), HF and reduced ejection fraction (HFrEF, n=55), pulmonary hypertension without left-heart failure (PAH, n=18), and control subjects (n=30) underwent cardiopulmonary exercise testing with invasive hemodynamic monitoring and first-pass radionuclide ventriculography. PV distensibility was derived from 1257 matched measurements (mean±SD, 8±2 per subject) of PA pressure, PA wedge pressure and cardiac output. PV distensibility was lowest in the PAH group (0.40±0.24% per mmHg) and intermediate in the HFpEF and HFrEF groups (0.92±0.39 and 0.84±0.33% per mmHg, respectively) compared to the control group (1.39±0.32% per mmHg, P<0.0001 for all three). PV distensibility was associated with change in RVEF (ρ=0.39, P<0.0001) with exercise and was an independent predictor of peak VO2. PV distensibility also predicted cardiovascular mortality independent of peak VO2 in HF patients (n=103, Cox HR 0.30, 95% CI 0.10–0.93, P=0.036). In a subset of HFrEF patients (n=26), 12 weeks of treatment with the pulmonary vasodilator sildenafil or placebo led to a 24.6% increase in PV distensibility (P=0.015) in the sildenafil group only. Conclusions PV distensibility is reduced in patients with HF and PAH and is closely related to RV systolic function during exercise, maximal exercise capacity, and survival. Furthermore, PV distensibility is modifiable with selective pulmonary vasodilator therapy and may represent an important target for therapy in selected HF patients with pulmonary hypertension. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00309790.

show abstract

“…In present study, out of 40 dogs, male dogs were 25 and female dogs were 15. Kasai et al, [9] found that the right pulmonary artery distensibility (RPAD) index has been used in dogs with pulmonary hypertension (PH) caused by heartworm infection, myxomatous mitral valve disease, or patent ductus arteriosus. The RPAD index and the ratios of acceleration time to peak pulmonary artery flow (AT) and to the ejection time of pulmonary artery flow (ET) were recorded for each dog.…”

Section: Discussionmentioning

confidence: 99%

To Assess the Clinical Value of the RPAD Index in Dogs with Varying Degrees of Pulmonary Hypertension

Nijhawan¹,

Chawla²,

Saxena³

et al. 2019

AJMR

View full text Add to dashboard Cite

Background: The gold standard for pulmonary artery pressure measurement is right heart catheterization. The present study was conducted to assess the clinical value of the RPAD index in dogs with varying degrees of pulmonary hypertension. Subjects and Methods: The present study was conducted on 40 dogs. Dogs were divided in four groups according to the TRPG value (<36 mmHg, 36-50 mmHg, 51-75 mmHg, or >75 mmHg). In all dogs, presence of signs commonly associated with PH was recorded. Results: Out of 40 dogs, male dogs were 25 and female dogs were 15. Common clinical features were coughing in 24, tachypnea in 11, weakness in 18, dyspnea in 27, syncope in 5 and hemoptysis in 34. The mean heart rate in group I was 130.2, in group II was 121.4, in group III was 141.3 and in group IV was 147.5. Clinical score in group I was 2.5, in group II was 3.7, in group III was 5.11 and in group IV was 5.8. Mean radiology score was 1.3 in group I, 2.4 in group II, 2.9 in group III and 3.8 in group IV. Fractional shortening was 46.5% in group I, 50.3% in group II, 55.4% in group III and 53.2% in group IV. The difference was significant (P< 0.05). Conclusion: Authors found significant difference in mean heart rate, clinical score, radiology score and fractional shortening in dogs with different pulmonary pressure.

show abstract

Electrocardiogram-Gated 320-Slice Multidetector Computed Tomography for the Measurement of Pulmonary Arterial Distensibility in Chronic Thromboembolic Pulmonary Hypertension

Cited by 13 publications

References 23 publications

Analysis of elasticity characteristics of ascending aorta, descending aorta and pulmonary artery using 640 slice-volume CT

Analysis of elasticity characteristics of ascending aorta, descending aorta and pulmonary artery using 640 slice-volume CT

Pulmonary Vascular Distensibility Predicts Pulmonary Hypertension Severity, Exercise Capacity, and Survival in Heart Failure

To Assess the Clinical Value of the RPAD Index in Dogs with Varying Degrees of Pulmonary Hypertension

Contact Info

Product

Resources

About