Journal article
Abstract 12824: Non-Invasive Prediction of Pulmonary Hypertension Using Computerized Tomography
Circulation (New York, N.Y.), Vol.138(Suppl_1 Suppl 1), pp.A12824-A12824
06 Nov 2018
Abstract
IntroductionAccurate diagnosis of pulmonary hypertension (PH) is made using invasive right heart catheterization (RHC). Prior studies have shown the utility of imaging techniques like computerized tomography (CT) as alternatives to predict PH.HypothesisTo determine the predictive ability of CT measured main pulmonary artery diameter (PA) to aortic diameter (AO) ratio in identifying PH.MethodsA retrospective observational study conducted in 211 consecutive patients who had RHC and CT chest within 6 months of each other between the years 2012-2015. Two expert radiologists measured main PA diameter at the bifurcation and AO diameter from the same CT image. Furthermore, we conducted a sub-group analysis to see if the ratio performs better in assessing PH in chronic kidney disease patients. Linear correlation and logistic regression analysis was used to examine the association between PA:AO ratio by CT scan with invasive hemodynamics. Receiver operator characteristic analysis was used to evaluate the ability of using PA:AO ratio to predict PH. Resting PH was defined as mean pulmonary artery pressure of ≥25 mmHg. CKD was defined as GFR between 15- 60 mL/min/ 1.73 m and no indication for dialysis.ResultsMean time between CT and RHC 3 days with minimum of 5.06 months (-152 days) to 5.56 months (167 days). Intraclass correlation coefficient between the two radiologists was 0.86 (95% CI of 0.75-0.92) with a P <0.01. CT measured PA:AO is highly correlated with mPAP after adjustment of age, race and gender (r=0.37, P<0.001). In a multivariate logistic model, every 0.15 U (1±SD) increase in PA:AO ratio was associated with 2.99 times higher (95% CI 1.99-4.49, P<0.01) odds of having PH , while in CKD subgroup, every 0.15 U (1±SD) increase in PA:AO ratio was associated with 11.9 times higher odds of having PH (95% CI 2.10-67.6, P =0.005), adjusting for age, race and gender.ConclusionCT derived PA:AO ratio is predictive of PH.
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- Title
- Abstract 12824: Non-Invasive Prediction of Pulmonary Hypertension Using Computerized Tomography
- Creators
- Reshma Golamari - Internal Medicine, Mercy Catholic Med Cntr, Yeadon, PAAsif Hameed - Internal Medicine, Mercy Catholic Med Cntr, Darby, PAHarsh Bhatt - Internal Medicine, Mercy Catholic Med Cntr, Darby, PASufana Shikdar - Internal Medicine, Mercy Catholic Med Cntr, Darby, PAShengnan Zheng - Internal Medicine, Mercy Catholic Med Cntr, Darby, PAAbhishek Bharadwaj - Internal Medicine, Presbyterian Hosp, Philadelphia, PAAjay Pillai - Internal Medicine, Mercy Catholic Med Cntr, Darby, PAOleg Teytelboym - Sisters of Mercy Health SystemWei Yang - Cntr for Clinical Epidemiology and Biostatistics, Perelman Sch of Medicine, Univ of Pennsylvania, Philadelphia, PAAparna Babu - Dept of Radiology, Mercy Catholic Med Cntr, Darby, PAJeremy Mazurek - Dept of Cardiovascular Medicine, Advanced Heart Failure/ Cardiac transplantation and Pulmonary, Hosp of Univ of Pennsylvania, Perelman Cntr for Advanced Medicine, Philadelphia, PAPriyanka Bhattacharya - Internal Medicine, Mercy Catholic Med Cntr, Drexel Univ College of Medicine,Cntr for Clinical Epidemiology and Biostatistics, Philadelphia, PA
- Publication Details
- Circulation (New York, N.Y.), Vol.138(Suppl_1 Suppl 1), pp.A12824-A12824
- Publisher
- by the American College of Cardiology Foundation and the American Heart Association, Inc
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate)
- Identifiers
- 991019170409204721