Background: Early diagnosis of pulmonary hypertension (PH) can potentially improve survival and quality of life.\r\nDetecting PH using echocardiography is often insensitive in subjects with lung fibrosis or hyperinflation. Right\r\nheart catheterization (RHC) for the diagnosis of PH adds risk and expense due to its invasive nature. Pre-defined\r\nmeasurements utilizing computed tomography (CT) of the chest may be an alternative non-invasive method of\r\ndetecting PH.\r\nMethods: This study retrospectively reviewed 101 acutely hospitalized inpatients with heterogeneous diagnoses,\r\nwho consecutively underwent CT chest and RHC during the same admission. Two separate teams, each consisting\r\nof a radiologist and pulmonologist, blinded to clinical and RHC data, individually reviewed the chest CT�s.\r\nResults: Multiple regression analyses controlling for age, sex, ascending aortic diameter, body surface area, thoracic\r\ndiameter and pulmonary wedge pressure showed that a main pulmonary artery (PA) diameter =29 mm (odds ratio\r\n(OR) = 4.8), right descending PA diameter =19 mm (OR = 7.0), true right descending PA diameter = 16 mm (OR =\r\n4.1), true left descending PA diameter = 21 mm (OR = 15.5), right ventricular (RV) free wall = 6 mm (OR = 30.5),\r\nRV wall/left ventricular (LV) wall ratio =0.32 (OR = 8.8), RV/LV lumen ratio =1.28 (OR = 28.8), main PA/ascending\r\naorta ratio =0.84 (OR = 6.0) and main PA/descending aorta ratio = 1.29 (OR = 5.7) were significant predictors of PH\r\nin this population of hospitalized patients.\r\nConclusion: This combination of easily measured CT-based metrics may, upon confirmatory studies, aid in the\r\nnon-invasive detection of PH and hence in the determination of RHC candidacy in acutely hospitalized patients.
Loading....