Accuracy of CT Pulmonary Artery Diameter for Pulmonary Hypertension in End-Stage COPD

Autor: Esther Pompe, Tim Besselink, Erik Jan D Oudijk, Ed A. van de Graaf, Pim A. de Jong, Bart Luijk, J.M. Kwakkel-van Erp, Firdaus A. A. Mohamed Hoesein
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Spirometry
Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
medicine.medical_treatment
Hypertension
Pulmonary
030204 cardiovascular system & hematology
Pulmonary Artery
Article
Pulmonary function testing
03 medical and health sciences
Pulmonary Disease
Chronic Obstructive
0302 clinical medicine
Predictive Value of Tests
Internal medicine
medicine.artery
Forced Expiratory Volume
medicine
Journal Article
Radiology and other imaging
Lung transplantation
COPD
Humans
Arterial Pressure
Aorta
Aged
Retrospective Studies
medicine.diagnostic_test
business.industry
Pulmonary circulation and pulmonary hypertension
Organ Size
Middle Aged
medicine.disease
Pulmonary hypertension
030228 respiratory system
Predictive value of tests
Heart catheterization
Pulmonary artery
Cardiology
Female
business
Tomography
X-Ray Computed
Zdroj: Lung
Lung, 194(5), 813. Springer New York
ISSN: 1432-1750
0341-2040
Popis: INTRODUCTION: Pulmonary hypertension (PH) in COPD is associated with a higher mortality and an increased risk on exacerbations compared to COPD patients without PH. The aim was to evaluate the diagnostic value of pulmonary artery (PA) measurements on chest computed tomography (CT) for PH in end-stage COPD. METHODS: COPD patients evaluated for eligibility for lung transplantation between 2004 and 2015 were retrospectively analyzed. Clinical characteristics, chest CTs, spirometry, and right-sided heart catheterizations (RHC) were studied. Diameters of PA and ascending aorta (A) were measured on CT. Diagnostic properties of different cut-offs of PA diameter and PA:A ratio in diagnosing PH were calculated. RESULTS: Of 92 included COPD patients, 30 (32.6 %) had PH at RHC (meanPAP > 25 mm Hg). PA:A > 1 had a negative predictive value (NPV) of 77.9 % and a positive predictive value (PPV) of 63.1 % with an odds ratio (OR (CI 95 %)) of 5.60 (2.00-15.63). PA diameter ≥30 mm had a NPV of 78 % and PPV of 64 % with an OR (CI 95 %) of 6.95 (2.51-19.24). CONCLUSION: A small PA diameter and PA:A make the presence of PH unlikely but cannot exclude its presence in end-stage COPD. A large PA diameter and PA:A maybe used to detect PH early.
Databáze: OpenAIRE
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