Pulmonary Vascular Disease |

Right Ventricular Systolic Pressure and Pulmonary Artery Diameter in Pulmonary Arterial Hypertension Associated With Scleroderma FREE TO VIEW

Julianne Nichols, DO; Electra Kaloudis, MD; D. Datta, MD; Raymond Foley, DO
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University of Connecticut Health Center, Farmington, CT

Chest. 2014;146(4_MeetingAbstracts):836A. doi:10.1378/chest.1958177
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SESSION TITLE: DVT/PE/Pulmonary Hypertension Posters III

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Pulmonary Artery Hypertension (PAH) in Scleroderma has a prevalence rate of 30-60% and Right Ventricular Systolic Pressure (RVSP) on echocardiogram (ECHO) is the first sign that PAH may be present. Pulmonary artery diameter (dPA) on chest Computed Tomogram (CT) > 2.9cm and dPA/ dAo (Aorta diameter) >1 has been reported to indicate pulmonary arterial hypertension (PAH) but results are variable with pulmonary fibrosis that many scleroderma patients have. The relation of dPA on CT with RVSP on (ECHO) in patients with Pulmonary Artery Hypertension associated with Scleroderma (Scl-PAH) has not been explored. The objective of this study was to determine if RVSP correlates with dPA and dPA/dAo in patients with Scl-PAH.

METHODS: Medical records of 31 patients with Scl-PAH being treated at the Pulmonary Hypertension Center of our institution over the last 5 years were reviewed. Patient demographics and RVSP on ECHO was noted. Patients CT scans at time of initial evaluation were reviewed with a radiologist. dPA was measured in the axial sections on mediastinal window settings, 1 cm proximal to the level of the bifurcation of the main pulmonary artery, using electronic calipers. dAo was measured at the same level as dPA. Pearson’s test for linear correlation was used to calculate correlation coefficient (r) and determine the relationship between RVSP and dPA and dPA/dAO respectively. p ≤ 0.05 was deemed statistically significant.

RESULTS: Of 31 patients, 75% were females. Mean age was: 64±11 years. Majority of the patients (86%) had evidence of concomitant interstitial lung disease with varying degresss of fibrosis on CT chest. On ECHO, mean RVSP of studied subjects was: 56 ±17 mmHg . Mean dPA on CT chest was 3.38 ± 0.48 cm. Mean dPA/dAo was 1.14 ± 0.1. On Pearson’s test for linear correlation, no significant correlation was seen between dPA and RVSP (r= 0.147; p=0.42) or between RVSP and dPA/dAO (r =−0.05, p=0.78)

CONCLUSIONS: In patients with Scl-PAH, dPA on chest CT did not correlate with RVSP measured on ECHO and may have limited utility (in conjunction with RVSP) in identifying which Scleroderma patients have Pulmonary Artery Hypertension.

CLINICAL IMPLICATIONS: Whether dPA and dPA/dAo on CT chest can be used to identify which Scleroderma patients have Pulmonary Artery Hypertension should be addressed in future studies with a larger number of patients.

DISCLOSURE: The following authors have nothing to disclose: Julianne Nichols, Electra Kaloudis, D. Datta, Raymond Foley

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