CTA-derived left to right atrial size ratio distinguishes between pulmonary hypertension due to heart failure and idiopathic pulmonary arterial hypertension

Autor: J. Tim Marcus, Anna E. Huis In ‘t Veld, Anton Vonk Noordegraaf, Harm-Jan Bogaard, Alexander G. Van Vliet, M. Louis Handoko, Onno A. Spruijt
Přispěvatelé: Pulmonary medicine, ICaR - Heartfailure and pulmonary arterial hypertension, Cardiology, Physics and medical technology
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
Computed Tomography Angiography
Magnetic Resonance Imaging
Cine
030204 cardiovascular system & hematology
Ventricular Function
Left
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Cardiac magnetic resonance imaging
Internal medicine
medicine
Humans
Familial Primary Pulmonary Hypertension
Heart Atria
cardiovascular diseases
Pulmonary wedge pressure
Aged
Retrospective Studies
Computed tomography angiography
Heart Failure
medicine.diagnostic_test
Cardiac cycle
business.industry
Stroke Volume
Middle Aged
medicine.disease
Pulmonary hypertension
medicine.anatomical_structure
Heart failure
Vascular resistance
Cardiology
Atrial Function
Left
Female
Cardiology and Cardiovascular Medicine
business
Heart failure with preserved ejection fraction
Follow-Up Studies
Zdroj: Huis in' t Veld, A, Van Vliet, A G, Spruijt, O A, Handoko, M L, Marcus, J T, Noordegraaf, A V & Bogaard, H-J 2016, ' CTA-derived left to right atrial size ratio distinguishes between pulmonary hypertension due to heart failure and idiopathic pulmonary arterial hypertension ', International Journal of Cardiology, vol. 223, pp. 723-728 . https://doi.org/10.1016/j.ijcard.2016.08.314
International Journal of Cardiology, 223, 723-728. Elsevier Ireland Ltd
ISSN: 0167-5273
Popis: Background/objectives Assessing atrial sizes by routine non-gated CT-angiography (CTA) could be of value in discriminating between pulmonary hypertension (PH) due to heart failure with preserved ejection fraction (HFpEF) and idiopathic pulmonary arterial hypertension (IPAH). We aimed to determine how left (LA) and right atrial (RA) sizes on non-gated CTA can help discriminate between these patients. Methods and results In an initial study, CMR was used in 15 IPAH and 15 PH-HFpEF patients to determine LA- and RA size throughout the cardiac cycle. While significant variations were noted in LA size over the cardiac cycle, the calculated ratio of left over right atrial size (LA/RA ratio) remained stable in both groups and discriminated between PH-HFpEF and IPAH. In a second study, routine non-gated CTA was used to validate the diagnostic use of a LA/RA ratio in 95 consecutive treatment-naive patients with a final diagnosis of either IPAH (n=64) or PH-HFpEF (n=31). ROC analyses were conducted to determine the discriminative properties of atrial size parameters. On a transversal view, LA size was 19cm 2 (±5) in the IPAH group versus 27cm 2 (±6) in the PH-HFpEF group ( p Conclusions Assessing LA/RA size ratio by non-gated CTA allows for accurate discrimination between PH-HFpEF and IPAH patients. Because CTA is often available in the early diagnostic work-up, a LA/RA size ratio may guide clinical and diagnostic decision-making, even before invasive hemodynamic measurements.
Databáze: OpenAIRE
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