Shahin, Y. orcid.org/0000-0001-7425-7798, Alabed, S. orcid.org/0000-0002-9960-7587, Alkhanfar, D. et al. (6 more authors) (2022) Quantitative CT evaluation of small pulmonary vessels has functional and prognostic value in pulmonary hypertension. Radiology, 305 (2). pp. 431-440. ISSN 0033-8419
Abstract
Background: The in vivo relationship between peel pulmonary vessels, small pulmonary vessels, and pulmonary hypertension (PH) is not fully understood. Purpose: To quantitatively assess peel pulmonary vessel volumes (PPVVs) and small pulmonary vessel volumes (SPVVs) as estimated from CT pulmonary angiography (CTPA) in different subtypes of PH compared with controls, their relationship to pulmonary function and right heart catheter metrics, and their prognostic value. Materials and Methods: In this retrospective single-center study performed from January 2008 to February 2018, quantitative CTPA analysis of total SPVV (TSPVV) (0.4- to 2-mm vessel diameter) and PPVV (within 15, 30, and 45 mm from the lung surface) was performed. Results: A total of 1823 patients (mean age, 69 years 6 13 [SD]; 1192 women [65%]) were retrospectively analyzed; 1593 patients with PH (mean pulmonary arterial pressure [mPAP], 43 mmHg 6 13 [SD]) were compared with 230 patient controls (mPAP, 19 mm Hg 6 3). The mean vessel volumes in pulmonary peels at 15-, 30-, and 45-mm depths were higher in pulmonary arterial hypertension (PAH) and PH secondary to lung disease compared with chronic thromboembolic PH (45-mm peel, mean difference: 6.4 mL [95% CI: 1, 11] [P , .001] vs 6.8 mL [95% CI: 1, 12] [P = .01]). Mean small vessel volumes at a diameter of less than 2 mm were lower in PAH and PH associated with left heart disease compared with controls (1.6-mm vessels, mean difference: 24.3 mL [95% CI: 28, 20.1] [P = .03] vs 26.8 mL [95% CI: 211, 22] [P , .001]). In patients with PH, the most significant positive correlation was noted with forced vital capacity percentage predicted (r = 0.30-0.40 [all P , .001] for TSPVVs and r = 0.21-0.25 [all P , .001] for PPVVs). Conclusion: The volume of pulmonary small vessels is reduced in pulmonary arterial hypertension and pulmonary hypertension (PH) associated with left heart disease, with similar volume of peel vessels compared with controls. For chronic thromboembolic PH, the volume of peel vessels is reduced. In PH, small pulmonary vessel volume is associated with pulmonary function tests.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Authors. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Aged; Female; Humans; Computed Tomography Angiography; Heart Diseases; Hypertension, Pulmonary; Lung; Prognosis; Pulmonary Arterial Hypertension; Pulmonary Artery; Retrospective Studies |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > Department of Infection, Immunity and Cardiovascular Disease The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Funding Information: | Funder Grant number WELLCOME TRUST (THE) 205188/Z/16/Z WELLCOME TRUST (THE) 206632/Z/17/Z MEDICAL RESEARCH COUNCIL MR/M008894/1 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 30 Aug 2023 15:44 |
Last Modified: | 30 Aug 2023 15:44 |
Status: | Published |
Publisher: | Radiological Society of North America (RSNA) |
Refereed: | Yes |
Identification Number: | 10.1148/radiol.210482 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:202819 |