High-Resolution Chest Computed Tomography Findings Do Not Predict the Presence of Pulmonary Hypertension in Advanced Idiopathic Pulmonary Fibrosis

Zisman, David A.; Karlamangla, Arun S.; Ross, David J.; Keane, Michael P.; Belperio, John A.; Saggar, Rajan; Lynch, Joseph P.; Ardehali, A.; Goldin, Jonathan

doi:10.1378/chest.132.4_meetingabstracts.583

Cited by 9 publications

(10 citation statements)

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“…However, echocardiographic fi ndings may be inaccurate and thus lead to considerable overdiagnosis of pulmonary arterial hypertension, and they do not enable direct measurement of PVR ( 9 ). The diagnostic usefulness of measuring the size of the main pulmonary arterial diameter within 3 cm of the bifurcation on computed tomographic (CT) scans, which has been proposed as having 84% sensitivity and 75% specifi cityalbeit without having direct correlation with pulmonary arterial pressure ( 10 )-has not been confi rmed in subsequent larger studies ( 11 ). Time-resolved magnetic resonance (MR) angiography is a noninvasive technique that enables not only anatomic imaging of the pulmonary vasculature but also evaluation of the hemodynamics ( 12,13 ).…”

Section: Patientsmentioning

confidence: 99%

Combined Pulmonary Fibrosis and Emphysema: 3D Time-resolved MR Angiographic Evaluation of Pulmonary Arterial Mean Transit Time and Time to Peak Enhancement

Sergiacomi

Bolacchi²,

Cadioli³

et al. 2010

Radiology

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Purpose:To correlate conventional invasive pressure indexes of pulmonary circulation with pulmonary fi rst-order arterial mean transit time (MTT) and time to peak enhancement (TTP) measured by means of three-dimensional timeresolved magnetic resonance (MR) angiography in patients with combined pulmonary fi brosis and emphysema (CPFE). Materials and Methods:The study was institutional review board approved. All subjects involved in the study provided written informed consent. Eighteen patients with CPFE were enrolled in this study. Thirteen healthy individuals matched for age and sex served as control subjects. Three-dimensional timeresolved MR angiography was performed by using a 3.0-T MR imager. Regions of interest (ROIs) were drawn manually on fi rst-order pulmonary arteries. Within the ROIs, signal intensity-versus-time curves refl ecting the fi rst pass of the contrast agent bolus in the pulmonary vessels were obtained. MTT and TTP were calculated. Pulmonary arterial pressure and pulmonary capillary wedge pressure were measured with a double-lumen, balloon-tipped catheter that was positioned in the pulmonary artery. The mean pulmonary arterial pressure (mPAP) and the pulmonary vascular resistance (PVR) were determined. Results:MTT and TTP values were prolonged signifi cantly in patients with CPFE compared with those in the control subjects ( P , .001). Mean TTP and mean MTT correlated directly with mPAP and PVR index ( P , .005). At multiple linear regression analysis, MTT was the only factor independently associated with PVR index and mPAP. Conclusion:Three-dimensional time-resolved MR angiography enables determination of pulmonary hemodynamic parameters that correlate signifi cantly with the pulmonary hemodynamic parameters obtained with invasive methods and may represent a complementary tool for evaluating pulmonary hypertension in patients with CPFE.

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Section: Patientsmentioning

confidence: 99%

Combined Pulmonary Fibrosis and Emphysema: 3D Time-resolved MR Angiographic Evaluation of Pulmonary Arterial Mean Transit Time and Time to Peak Enhancement

Sergiacomi

Bolacchi²,

Cadioli³

et al. 2010

Radiology

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“…Although echocardiography and CT-determined main pulmonary artery diameter are commonly used tests to screen for PH in patients with IPF, they are not reliable. 4,8,9 Reliable, noninvasive approaches to the diagnosis of PH in patients with IPF would improve patient safety, reduce costs, and enable the appropriate timing of RHC.…”

mentioning

confidence: 99%

Validation of a Method To Screen for Pulmonary Hypertension in Advanced Idiopathic Pulmonary Fibrosis

Zisman

Karlamangla

Kawut

et al. 2008

Chest

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“…Thus, in the patients with PH in the course of DPLDs, Kco should theoretically be lower than in the patients with ILDs without PH. Nevertheless, Zisman et al didn't find significant difference of Kco between the IPF patients with PH confirmed by RHC and those without PH [33].…”

Section: Plethysmography and Dlcomentioning

confidence: 91%

“…According to many published data, the development of PH should be suspected in patients with DLCO decreased disproportionally to the degree of PFT disturbances [17][18][19][20]33]. The criterion of low DLCO used for PH prediction was the value below 40% pred.…”

Section: Plethysmography and Dlcomentioning

confidence: 99%

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Pulmonary Hypertension in the Course of Diffuse Parenchymal Lung Diseases—State of Art and Future Considerations

Szturmowicz¹,

Kacprzak²,

Błasińska‐Przerwa³

et al. 2015

Advances in Respiratory Medicine

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Lung diseases are one of the most frequent causes of pulmonary hypertension (PH). The development of PH influences the course of lung disease, worsening the clinical symptoms and prognosis. According to the most recent publications, PH in the course of lung diseases develops as a result of both "parenchymal" and vascular pathology, in the patients with genetic predisposition. Prolonged infection (especially viral one) may be an additional promoting factor. Right heart catheterization (RHC), which is an invasive procedure, is the only objective method of diagnosing PH. According to the latest recommendations, the management algorithm of PH and coexisting interstitial lung disease is based on RHC and the results of pulmonary function tests. Majority of the patients develop mild PH in the course of advanced lung disease. Best treatment of underlying lung pathology combined with long term oxygen treatment is recommended in this group. In case of severe PH (mean resting pulmonary artery pressure (mPAP) ≥ 35 mm Hg) the alternate cause of PH has to be sought. PAH-specific drugs use should be limited to patients with severe PH participating in clinical trials. In this review, the value of various non-invasive methods (echocardiography, radiological examination, exercise capacity and brain natriuretic peptides assessment) in the process of screening for PH is presented, and the results of recent randomized clinical trials with PAH-specific drugs in patients with diffuse parenchymal lung diseases are discussed.

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High-Resolution Chest Computed Tomography Findings Do Not Predict the Presence of Pulmonary Hypertension in Advanced Idiopathic Pulmonary Fibrosis

Cited by 9 publications

References 0 publications

Combined Pulmonary Fibrosis and Emphysema: 3D Time-resolved MR Angiographic Evaluation of Pulmonary Arterial Mean Transit Time and Time to Peak Enhancement

Combined Pulmonary Fibrosis and Emphysema: 3D Time-resolved MR Angiographic Evaluation of Pulmonary Arterial Mean Transit Time and Time to Peak Enhancement

Validation of a Method To Screen for Pulmonary Hypertension in Advanced Idiopathic Pulmonary Fibrosis

Pulmonary Hypertension in the Course of Diffuse Parenchymal Lung Diseases—State of Art and Future Considerations

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