PURPOSE: Review the X ray from the chest of those patients in order to measure the diameter of the right interlobar artery in PA projection and to compare it with SPPA with echocardiography for early diagnosis of PH
METHODS: We reviewed 35 records from patients diagnosed with PH included patients group I Dana Point in functional class I, II and III, between January 2009 and December 2010 in our Referral Center for PAH in Mexico City. 30 patients, 19 women (63%) and 11 men (37%). 62.4 years old + 14.93 years. The PAPm was 38.26 +/- 9.87 mm hg in all cases it was confirmed by RHC. All patients were classified using the NYHA-WHO tool. In group I were included 2/30 (7%), class II 15/30 (50%), class III 13/30 (43%) and no patients from class IV. The mean of SPPA by echo Doppler was 60.27 sd 16.18 mmHg. The diameter of interlobar artery was determined by 1 radiologist and 1 pulmonologist, the mean reported for the observer 1 was 27.04 +/- 3.70 mm, and the mean reported for observer 2 was 27.12 +/- 3.88 mm.
RESULTS: In T test were: T= -0.27 (p= 0.79), however in the group with functional class III, using Pearson method, we observed that the diameter in interlobar artery was 27.036 + 3.084 mm and SPPA was 72.69 + 12.62 mmHg with 96% correlation (p=0.17).
CONCLUSIONS: We consider that late clinical feature with signs in the X ray from the chest correlates with early changes in the echocardiogram, such as the increase of SPPA without consideration of any other data of right ventricular dysfunction, and this contributes to a delayed diagnosis of Pulmonary Hypertension.
CLINICAL IMPLICATIONS: The echo is more sensitive for early diagnosis if one considers the clinical aspects and the X ray is effective to establish differential diagnoses.
DISCLOSURE: The following authors have nothing to disclose: Guadalupe Espitia Hernandez, J. Arturo Vazquez Leduc
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