Computed Tomography Pulmonary Angiogram Dynamic Parameter Correlation With Pulmonary Pressure and Pulmonary Hypertension Etiologies

Yoel Siegel, Drew Bleicher, Michael Kurt Gordon, Debra Fertel

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Pulmonary hypertension (PH) is caused by etiologies that differ in pathophysiology. Patients with undiagnosed PH may have a computed tomography pulmonary angiography (CTPA) scan during workup. Static measurements on computed tomography correlate with PH; however, dynamic parameters have received less attention. We studied the correlation between CTPA dynamic parameters and PH and assessed whether these parameters differ among PH etiologies. We also propose a method for PH screening. METHODS: Patients who underwent right-heart catheterization and CTPA within 45 days of each other were included. Charts were reviewed for presence and etiology of PH. The time it took to reach the CTPA trigger threshold during bolus tracking (TT) was recorded and compared with pulmonary pressure measured on pulmonary artery catheterization. The correlation between TT values and pulmonary pressure was studied, as well as the sensitivity and specificity of TT for PH. RESULTS: Twenty-seven patients with 28 examinations were included. A significant correlation was found between pulmonary pressure and TT, as well as TT and right ventricular decreased function, P < 0.01. Left heart failure showed the longest TT among PH subgroups and significantly longer TT in patients with both PH and right ventricular decreased function. Time to trigger demonstrated a sensitivity range of 75% to 92% and specificity between 56% and 88% for pulmonary pressure of 40 mm Hg or greater. CONCLUSIONS: Dynamic parameters of flow measured on CTPA significantly correlate with pulmonary pressure and can potentially help screen for PH. Left heart failure seems to have the greatest impact on TT among patients with PH.

Original languageEnglish (US)
JournalJournal of Computer Assisted Tomography
DOIs
StateAccepted/In press - Feb 24 2017

Fingerprint

Pulmonary Hypertension
Angiography
Tomography
Pressure
Lung
Right Ventricular Function
Heart Failure
Swan-Ganz Catheterization
Cardiac Catheterization
Computed Tomography Angiography
Sensitivity and Specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Computed Tomography Pulmonary Angiogram Dynamic Parameter Correlation With Pulmonary Pressure and Pulmonary Hypertension Etiologies. / Siegel, Yoel; Bleicher, Drew; Gordon, Michael Kurt; Fertel, Debra.

In: Journal of Computer Assisted Tomography, 24.02.2017.

Research output: Contribution to journalArticle

@article{e462cab3e31c49e087a0349f5739d439,
title = "Computed Tomography Pulmonary Angiogram Dynamic Parameter Correlation With Pulmonary Pressure and Pulmonary Hypertension Etiologies",
abstract = "OBJECTIVE: Pulmonary hypertension (PH) is caused by etiologies that differ in pathophysiology. Patients with undiagnosed PH may have a computed tomography pulmonary angiography (CTPA) scan during workup. Static measurements on computed tomography correlate with PH; however, dynamic parameters have received less attention. We studied the correlation between CTPA dynamic parameters and PH and assessed whether these parameters differ among PH etiologies. We also propose a method for PH screening. METHODS: Patients who underwent right-heart catheterization and CTPA within 45 days of each other were included. Charts were reviewed for presence and etiology of PH. The time it took to reach the CTPA trigger threshold during bolus tracking (TT) was recorded and compared with pulmonary pressure measured on pulmonary artery catheterization. The correlation between TT values and pulmonary pressure was studied, as well as the sensitivity and specificity of TT for PH. RESULTS: Twenty-seven patients with 28 examinations were included. A significant correlation was found between pulmonary pressure and TT, as well as TT and right ventricular decreased function, P < 0.01. Left heart failure showed the longest TT among PH subgroups and significantly longer TT in patients with both PH and right ventricular decreased function. Time to trigger demonstrated a sensitivity range of 75{\%} to 92{\%} and specificity between 56{\%} and 88{\%} for pulmonary pressure of 40 mm Hg or greater. CONCLUSIONS: Dynamic parameters of flow measured on CTPA significantly correlate with pulmonary pressure and can potentially help screen for PH. Left heart failure seems to have the greatest impact on TT among patients with PH.",
author = "Yoel Siegel and Drew Bleicher and Gordon, {Michael Kurt} and Debra Fertel",
year = "2017",
month = "2",
day = "24",
doi = "10.1097/RCT.0000000000000582",
language = "English (US)",
journal = "Journal of Computer Assisted Tomography",
issn = "0363-8715",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Computed Tomography Pulmonary Angiogram Dynamic Parameter Correlation With Pulmonary Pressure and Pulmonary Hypertension Etiologies

AU - Siegel, Yoel

AU - Bleicher, Drew

AU - Gordon, Michael Kurt

AU - Fertel, Debra

PY - 2017/2/24

Y1 - 2017/2/24

N2 - OBJECTIVE: Pulmonary hypertension (PH) is caused by etiologies that differ in pathophysiology. Patients with undiagnosed PH may have a computed tomography pulmonary angiography (CTPA) scan during workup. Static measurements on computed tomography correlate with PH; however, dynamic parameters have received less attention. We studied the correlation between CTPA dynamic parameters and PH and assessed whether these parameters differ among PH etiologies. We also propose a method for PH screening. METHODS: Patients who underwent right-heart catheterization and CTPA within 45 days of each other were included. Charts were reviewed for presence and etiology of PH. The time it took to reach the CTPA trigger threshold during bolus tracking (TT) was recorded and compared with pulmonary pressure measured on pulmonary artery catheterization. The correlation between TT values and pulmonary pressure was studied, as well as the sensitivity and specificity of TT for PH. RESULTS: Twenty-seven patients with 28 examinations were included. A significant correlation was found between pulmonary pressure and TT, as well as TT and right ventricular decreased function, P < 0.01. Left heart failure showed the longest TT among PH subgroups and significantly longer TT in patients with both PH and right ventricular decreased function. Time to trigger demonstrated a sensitivity range of 75% to 92% and specificity between 56% and 88% for pulmonary pressure of 40 mm Hg or greater. CONCLUSIONS: Dynamic parameters of flow measured on CTPA significantly correlate with pulmonary pressure and can potentially help screen for PH. Left heart failure seems to have the greatest impact on TT among patients with PH.

AB - OBJECTIVE: Pulmonary hypertension (PH) is caused by etiologies that differ in pathophysiology. Patients with undiagnosed PH may have a computed tomography pulmonary angiography (CTPA) scan during workup. Static measurements on computed tomography correlate with PH; however, dynamic parameters have received less attention. We studied the correlation between CTPA dynamic parameters and PH and assessed whether these parameters differ among PH etiologies. We also propose a method for PH screening. METHODS: Patients who underwent right-heart catheterization and CTPA within 45 days of each other were included. Charts were reviewed for presence and etiology of PH. The time it took to reach the CTPA trigger threshold during bolus tracking (TT) was recorded and compared with pulmonary pressure measured on pulmonary artery catheterization. The correlation between TT values and pulmonary pressure was studied, as well as the sensitivity and specificity of TT for PH. RESULTS: Twenty-seven patients with 28 examinations were included. A significant correlation was found between pulmonary pressure and TT, as well as TT and right ventricular decreased function, P < 0.01. Left heart failure showed the longest TT among PH subgroups and significantly longer TT in patients with both PH and right ventricular decreased function. Time to trigger demonstrated a sensitivity range of 75% to 92% and specificity between 56% and 88% for pulmonary pressure of 40 mm Hg or greater. CONCLUSIONS: Dynamic parameters of flow measured on CTPA significantly correlate with pulmonary pressure and can potentially help screen for PH. Left heart failure seems to have the greatest impact on TT among patients with PH.

UR - http://www.scopus.com/inward/record.url?scp=85014045123&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014045123&partnerID=8YFLogxK

U2 - 10.1097/RCT.0000000000000582

DO - 10.1097/RCT.0000000000000582

M3 - Article

C2 - 28240636

AN - SCOPUS:85014045123

JO - Journal of Computer Assisted Tomography

JF - Journal of Computer Assisted Tomography

SN - 0363-8715

ER -