PURPOSE: Pulmonary Hypertension (PH) is defined as Pulmonary Artery Pressure (PAP) >25 mm Hg. Although right heart catherization is the gold standard, 2D Echo is commonly used to detect PH and to grade its severity. 2D Echo detects PH based on the presence of tricuspid regurgitation and measurement of the regurgitant jet using the modified Bernoulli's equation (4 × velocity squared). PAP measurements between 21 and 40 mm Hg and > 40 mm Hg are consistent with Mild-moderate and severe pulmonary hypertension respectively.
METHODS: Retrospective review of 2D Echo and CT Scan results of 30 patients referred to pulmonary service over one year period for evaluation of parenchymal lung disease who were found to have pulmonary hypertension based on 2D Echo results. We measured the Mean Pulmonary Artery Diameter (MPAD) on the CT Scan at the widest portion of the main pulmonary artery within 3 cm of the bifurcation.
RESULTS: In our study we found that patients with 2D Echo PAP between 25-40 mm Hg graded as mild-moderate PH have CT determined mean MPAD 34 mm(SD =6.57) and those with PAP >40 mm Hg graded as severe PH have mean MPAD 48.5 mm(SD =7.45). There is statistically significant difference between the above two categories based on the Two-Sample T-Test (P-Value 0.001). Also we noted a linear correlation between the MPAD on CT Scan and PAP as measured by 2D Echo (P-Value 0.002).
CONCLUSION: CT Scan, a non invasive and readily available modality, is frequently used to evaluate chest pathology. Our study demonstrates that CT scan measurement of main pulmonary artery diameter (MPAD) can be a useful tool for detection and grading the severity of pulmonary hypertension.
CLINICAL IMPLICATIONS: Utility of CT scan for detection and grading the severity of pulmonary hypertension in patients with parenchymal lung disease.
DISCLOSURE: Roberto Santos, No Financial Disclosure Information; No Product/Research Disclosure Information