Electrocardiogram-gated 320-slice multidetector computed tomography for the measurement of pulmonary arterial distensibility in chronic thromboembolic pulmonary hypertension

PLoS One. 2014 Nov 3;9(11):e111563. doi: 10.1371/journal.pone.0111563. eCollection 2014.

Abstract

Background: We aimed to study whether pulmonary arterial distensibility (PAD) correlates with hemodynamic parameters in chronic thromboembolic pulmonary hypertension (CTEPH) using electrocardiogram (ECG)-gated 320-slice multidetector computed tomography (MDCT).

Methods and findings: ECG-gated 320-slice MDCT and right heart catheterization (RHC) was performed in 53 subjects (60.6±11.4 years old; 37 females) with CTEPH. We retrospectively measured the minimum and maximum values of the cross sectional area (CSA) of the main pulmonary artery (mainPA), right pulmonary artery (rtPA), and left pulmonary artery (ltPA) during one heartbeat. PAD was calculated using the following formula: PAD = [(CSAmaximum-CSAminimum)/CSAmaximum]×100(%). The correlation between hemodynamic parameters and PAD was assessed. Mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance (PVR) were 40.8±8.7 mmHg and 8.3±3.0 wood units, respectively. PAD values were as follows: mainPA (14.0±5.0%), rtPA (12.8±5.6%), and ltPA (9.7±4.6%). Good correlations existed between mainPAD, with mPAP (r = -0.594, p<0.001) and PVR (r = -0.659, p<0.001). The correlation coefficients between rtPAD and ltPAD with pulmonary hemodynamics were all lower or equal than for mainPAD.

Conclusions: PAD measured using ECG-gated 320-slice MDCT correlates with pulmonary hemodynamics in subjects with CTEPH. The mainPA is suitable for PAD measurement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chronic Disease
  • Female
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary / complications*
  • Hypertension, Pulmonary / mortality
  • Hypertension, Pulmonary / physiopathology
  • Hypertension, Pulmonary / therapy
  • Male
  • Middle Aged
  • Multidetector Computed Tomography*
  • Oxygen Inhalation Therapy
  • Piperazines / therapeutic use
  • Pulmonary Artery / diagnostic imaging*
  • Pulmonary Artery / physiopathology*
  • Pulmonary Embolism / etiology*
  • Pulmonary Embolism / mortality
  • Pulmonary Embolism / physiopathology
  • Pulmonary Embolism / therapy
  • Purines / therapeutic use
  • Risk Factors
  • Sildenafil Citrate
  • Sulfonamides / therapeutic use
  • Treatment Outcome
  • Vascular Capacitance*
  • Vasodilator Agents / therapeutic use

Substances

  • Piperazines
  • Purines
  • Sulfonamides
  • Vasodilator Agents
  • Sildenafil Citrate

Grants and funding

The authors have no support or funding to report.