Abstract 10968: Optical Coherence Tomography as a Novel Diagnostic Tool for Distal-type Chronic Thromboembolic Pulmonary Hypertension
Purpose: The classification of pulmonary hypertension (PH) has recently been updated, where the 5 major categories of the disorder have been determined. Among them, pulmonary arterial hypertension (PAH, class 1) and chronic thromboembolic pulmonary hypertension (CTEPH, class 4) are characterized with similar hemodynamic values of pulmonary circulation despite their different pathological vascular structures. In this study, we thus examined the usefulness of an optical coherence tomography (OCT) for differential diagnostic for distal-type CTEPH from PAH.
Methods: We have prospectively enrolled 44 consecutive patients with PH, including PAH (n=26), CTEPH (n=13) and normal hemodynamic subjects (control, n=5) in our hospital from February 2008 to March 2010. They underwent right heart catheterization including the OCT evaluation.
Results: In the controls or PAH, the pulmonary arteries larger than 1 mm had no obstruction, although the media of the arteries appeared to be thickened in PAH compared with the controls. In contrast, in all cases of CTEPH, we obtained unique and completely different OCT findings compared with the controls or PAH; 44% of the CTEPH patients had the occlusion of pulmonary arteries, probably by thrombus, and 67% of them showed flaps in the lumen of the pulmonary arteries (white arrows) .
Conclusions: The present results indicate that OCT is a useful tool for differential diagnosis of distal-type CTEPH from PAH.
- © 2010 by American Heart Association, Inc.