Abstract 15751: Estimation of Pulmonary Arterial Pressure in Subjects with Pulmonary Hypertension by Configuration of Right Ventricle Obtained by Electrocardiogram Gated Conventional Scan in 320 Slice CT
Purpose: To estimate pulmonary artery (PA) pressure in subjects with pulmonary hypertension (PH), we evaluated configuration of right ventricle (RV) obtained by retrospective ECG gated conventional scan using 320 slice CT compared with systolic (sPAP, [mmHg]) and mean PA pressure (mPAP, [mmHg]), and pulmonary vascular resistance (PVR, [dyne.sec.cm-5]) obtained by right heart catheterization (RHC).
Materials and Methods: 28 subjects (8 men, 55±11 yrs) with proven PH (19 chronic thromboembolic pulmonary hypertension and 9 PA hypertension) underwent enhanced 320 slice CT (Aquilion one) and RHC 1 month apart with no change in clinical status between the examinations. Images were reconstructed at end systole (ES) and end diastole (ED). We quantified wall thickness of RV myocardium in ED and ratio of RV to left ventricle (LV) short axis diameter in ES and evaluated abnormal shifts of interventricular septum (IVS) to LV in ES, and compared with RHC findings.
Results: RV wall thickness was 4.5±1.0 mm in ED and the ratio of RV/LV diameter in ES was 2.2±1.5. Abnormal shift of IVS to LV in ES was detected in 23 subjects. sPAP, mPAP, and PVR were 72.5±19.0, 42.7±10.9, and 669.8±288.0, respectively. The correlation coefficients of RV wall thickness in ED and ratio of RV/LV diameter in ES were 0.43 (P<0.05) and 0.75 (P<0.001) with sPAP, 0.43 (P<0.05) and 0.72 (P<0.001) with mPAP, and 0.27 (P=16) and 0.72 (P<0.001) with PVR, respectively. Not PVR but sPAP, and mPAP were significantly higher in subjects with abnormal shift of IVS to LV in ES (711±274 vs 480±300 [PVR] (P=0.11), 76.2±17.1 vs 55.6±20.3 [sPAP] (P=0.02), and; 45.3±9.2 vs 30.8±10.8 [PAMP] (P<0.01)). As some subjects with CTEPH required evaluation of coronary arteries before thrombectomy, we could evaluate coronary arteries with normal results in all subjects.
Conclusions: Conventional ECG gated scans with 320 slice CT can evaluate morphology of the RV as well as PA and coronary arteries and can estimate PA pressure in subjects with PH.
- © 2010 by American Heart Association, Inc.